KERRY JAMISON ELLIS – Social Worker, NPI 1114661550

KERRY JAMISON ELLIS is a healthcare provider. based in Pensacola, Florida. specializing in CLINICAL SOCIAL WORKER. They hold a License No. SW22815 (FL). The NPI Number for KERRY JAMISON ELLIS is 1114661550

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
KERRY JAMISON ELLIS
NPI
1114661550
Phone
(850) 436-4630
Address
2315 W JACKSON ST
Enumeration Date
22 April 2022
Last Update Date
20 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8504345033
Graduation Year
2021 (5 years ago)
PAC ID
1153866322
Group Practice PAC ID
1052388014
Professional Enrollment ID
I20240711002858
Address ID
FL325012608PE1120XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for KERRY JAMISON ELLIS

  • 2315 W JACKSON ST

    PENSACOLA, FL 325057552

    Phone: (850) 436-4630

    Type: Location

  • 1120 N PALAFOX ST

    PENSACOLA, FL 325012608

    Phone: (850) 434-5033

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240711002858IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32505)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052388014View full group profile
NameSpecialtyState
Clinical PsychologistFL
Clinical PsychologistLA
-FL
-FL
Mental Health CounselorFL
Mental Health CounselorFL
P S Y C H I A T R YFL
P S Y C H I A T R YAL
Clinical Social WorkerTX
P S Y C H I A T R YFL

Reviews

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Frequently asked questions

Can I verify KERRY JAMISON ELLIS with an NPI only?
You can start verification with NPI 1114661550 for KERRY JAMISON ELLIS, then check state licensing separately.
Does CMS list KERRY JAMISON ELLIS as active?
Yes — KERRY JAMISON ELLIS is active in the NPI listing used on this page.
What healthcare role does KERRY JAMISON ELLIS hold?
Scheduling teams often label KERRY JAMISON ELLIS under Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for KERRY JAMISON ELLIS?
KERRY JAMISON ELLIS's geographic hint is Pensacola, Florida in our summary view.
Is the information about KERRY JAMISON ELLIS up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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