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KENNETH RAY ELLIS MA
NPI 1700103934
Specialist in Johnson City, TN

Active since April 28, 2010
2243 EDDIE WILLIAMS RD, JOHNSON CITY, TN 37601(423) 928-5627(423) 467-3644 Get Directions Write a Review

NPPES record last updated: April 28, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth Ray Ellis Ma NPPES

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

KENNETH RAY ELLIS MA (NPI 1700103934) is an individual specialist in Johnson City, Tennessee and active in the NPI registry since April 2010.

NPPES Registry Identity

NPI1700103934
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameKENNETH RAY ELLISCredential: MA
Location Address2243 EDDIE WILLIAMS RDJohnson City, TN 37601-2872
Mailing Address1167 Spratlin Park DrGray, TN 37615-6205 · (423) 467-3600 · Fax (423) 467-3644
Phone(423) 928-5627
Fax(423) 467-3644
Sole ProprietorYes
Enumeration DateApril 28, 2010
✔ NPI 1700103934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2243 EDDIE WILLIAMS RD, Johnson City, TN 37601
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Other Providers at the Same Location NPPES 18

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

MRS. BARBARA S BAXLEY
Technician, Other
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 975-6000
CANDI MICHELLE DOULGAS
Counselor
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 928-5627
KEVIN LYNN THOMPSON BSW
Case Manager/Care Coordinator
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 975-6000
AARON JORDAN COX BA
Counselor
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 975-6000
SHOUNDA MICHELLE STEVENSON BS
Case Manager/Care Coordinator
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 928-5627
MRS. CAROLINE REAGAN HOLLAND MASTER OF SCIENCE
Technician, Other
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 928-5627
MEGAN BROOKE CLARK BS
Counselor
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 928-5627
KAREN S BARRETT BA
Counselor
2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN 37601
Washington County (423) 928-5627

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 Kenneth Ellis's NPI number?

The NPI number for Kenneth Ellis is 1700103934. It was assigned to this individual provider in the NPPES registry on April 28, 2010.

Where is Kenneth Ellis located?

Kenneth Ellis practices at 2243 Eddie Williams Rd, Johnson City, TN 37601. The listed phone number is (423) 928-5627.

What is Kenneth Ellis's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Kenneth Ellis was last updated on April 28, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.