Look up the most recent NPI and PECOS records

Ashley Garner Ellison

Internal Medicine

Allopathic & Osteopathic Physicians

3333 Brookview Hills Blvd, Winston Salem, NC 27103-5661

PECOS Enrollment

This provider is enrolled in PECOS as ASHLEY ELLISON.

Based on the most recent information from CMS, provider Ashley Garner Ellison is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1720345184
Provider Type
Individual
Full Name
Ellison, Ashley Garner
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/23/2012
Last Updated
4/30/2021

Contact Information

Practice Location

3333 Brookview Hills Blvd, Winston Salem, NC 27103-5661

(336) 765-5250

(336) 659-0953

Mailing Location

100 Kimel Forest Dr, Winston Salem, NC 27103-6074

(336) 716-1331

(336) 716-3202

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 2018-02364 North Carolina
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License MD.206753 Louisiana
Code 2084P0800X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License 2018-02364 North Carolina
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 2193066	Description Medicaid	Issuer Unlisted Louisiana
ID 00580093	Description Medicaid	Issuer Unlisted Mississippi

Ashley Garner Ellison

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer