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Ellery Parks

Physician β€’ Newnan, GA

Active NPI 1407346810 Individual Practitioner Female Practitioner
Practice location in NPPES

72 Preserve Dr
Newnan, GA 302632283

Call 8777410808 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

72 Preserve Dr

Newnan, GA 302632283

Telephone 8777410808

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-07-27
Home Health Primary Specialty

NUCC Taxonomy Code: 251E00000X

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 27, 2021

Registered at 72 PRESERVE DR, NEWNAN, GA 302632283 (Tel: 8777410808)

πŸ“
Updated Business Mailing Address June 23, 2021

Registered at PO BOX 73522, NEWNAN, GA 302713522 (Tel: 8777410808)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2021

Home Health

βœ…
NPI Profile Active May 11, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 11, 2018

Registered at 1717 S COLLEGE ST, AUBURN, AL 368325870 (Tel: 6786034909)

πŸ“
Business Mailing Address (Initial Record) May 11, 2018

Registered at PO BOX 595, AUBURN, AL 368310595 (Tel: 6787585010)

πŸ‘€
Provider Name / Credentials (Initial Record) May 11, 2018

Recorded as ELLERY PARKS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2018

Driver

🟒
Initial NPI Registration & Enumeration May 11, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1407346810
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 11, 2018
Last Update: July 27, 2021
Sole Proprietor: Yes

Mailing Address

Po Box 73522

Newnan, GA 302713522

Phone: 8777410808

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.