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MR. JUSTIN THOMAS ELLIS NP-BC, MSSM
NPI 1336959865
Nurse Practitioner - Family in Marietta, GA

Active since January 08, 2025PECOS Enrolled
1809 CANTON RD, MARIETTA, GA 30066(678) 335-4865 Get Directions Write a Review

NPPES record last updated: October 13, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Justin Thomas Ellis Np-bc, Mssm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JUSTIN THOMAS ELLIS NP-BC, MSSM (NPI 1336959865) is an individual family provider in Marietta, Georgia, licensed in Georgia (2024093910) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336959865
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. JUSTIN THOMAS ELLISCredential: NP-BC, MSSM
Location Address1809 CANTON RDMarietta, GA 30066-6343
Mailing Address4314 Sandy PointeAcworth, GA 30101-4975
Phone(678) 335-4865
Sole ProprietorNo
Enumeration DateJanuary 8, 2025
Last NPPES UpdateOctober 13, 2025
NPPES CertifiedOctober 13, 2025
✔ NPI 1336959865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · 2024093910
1809 CANTON RD, Marietta, GA 30066
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Justin Thomas Ellis Np-bc, Mssm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOEL E CARRION DC
Chiropractor
1809 CANTON RD
MARIETTA, GA 30066
Cobb County (678) 335-4865
BODY PROS PHYSICAL THERAPY
Clinic/Center (Physical Therapy)
1809 CANTON RD, SUITE 600
MARIETTA, GA 30066
Cobb County (678) 213-1560
PAUL A. MARINO P.T.
Physical Therapist
1809 CANTON RD, SUITE 600
MARIETTA, GA 30066
Cobb County (678) 213-1560

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Ellis's NPI number?

The NPI number for Justin Ellis is 1336959865. It was assigned to this individual provider in the NPPES registry on January 8, 2025.

Where is Justin Ellis located?

Justin Ellis practices at 1809 Canton Rd, Marietta, GA 30066. The listed phone number is (678) 335-4865.

What is Justin Ellis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Justin Ellis enrolled in Medicare?

Yes. Justin Ellis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Ellis was last updated on October 13, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.