SUZANNE IVIE ELLIS – Speech-Language Pathologist, NPI 1194565978

SUZANNE IVIE ELLIS is a healthcare provider. based in Smyrna, Georgia. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. The NPI Number for SUZANNE IVIE ELLIS is 1194565978

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
SUZANNE IVIE ELLIS
NPI
1194565978
Phone
Not provided
Address
4005 S COBB DR SE
Enumeration Date
29 May 2024
Last Update Date
29 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7703984195
Graduation Year
2024 (2 years ago)
PAC ID
4981192648
Group Practice PAC ID
0446754451
Professional Enrollment ID
I20251023003404
Address ID
GA300841930TU5844XHWYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

224 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in GA

Provider Addresses for SUZANNE IVIE ELLIS

  • 4005 S COBB DR SE

    SMYRNA, GA 300806307

    Phone:

    Mailing address matches the actual address.

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: 2025-10-23

PECOS data refreshed: 2026-06-15

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
I20251023003404IQualified Speech Language PathologistGATBD

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 30080)

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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: 0446754451View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeWI
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeCT
Occupational Therapist In Private PracticeCT

Reviews

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Frequently asked questions

What NPI should I save for SUZANNE IVIE ELLIS?
Save NPI 1194565978 if you need a stable reference for SUZANNE IVIE ELLIS.
Is SUZANNE IVIE ELLIS active in the national directory?
SUZANNE IVIE ELLIS's public NPI profile is in an active state.
What field does SUZANNE IVIE ELLIS work in?
You can think of SUZANNE IVIE ELLIS as practicing within Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What location shows for SUZANNE IVIE ELLIS?
We surface Smyrna, Georgia for SUZANNE IVIE ELLIS based on available NPPES addresses.
How can I contact SUZANNE IVIE ELLIS?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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