MRS. LATRESE ANN ELLIS (NP) – Family Nurse Practitioner, NPI 1861810749
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for MRS. LATRESE ANN ELLIS (NP)
9803 SPYGLASS DR
VILLA RICA, GA 301808416
Phone: (770) 312-8410
Type: Mailing
5764 Peachtree Industrial Blvd # 4505
Chamblee, GA 303411908
Phone: (770) 457-4401
Type: Location
4857 Zone Ave SW
Atlanta, GA 303317768
Phone: (404) 710-7550
Type: Location
5764 PEACHTREE INDUSTRIAL BLVD # 4505
CHAMBLEE, GA 303411908
Phone: (770) 457-4401
Type: Mailing
3800 PRINCETON LAKES PKWY SW
ATLANTA, GA 303315580
Phone: (404) 948-3019
Type: Location
2429 MARTIN LUTHER KING JR DR SW # 4717
ATLANTA, GA 303111713
Phone: (404) 691-9580
Type: Mailing
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: 2014-06-16
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140616000080 | I | Nurse Practitioner | GA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 91 | 85 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 83 | 78 | $0 |
Insurance plans in this area (ZIP 30180)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | SC | |
| Nurse Practitioner | GA | |
| Family Practice, General Practice | GA | |
| Physician Assistant | SC | |
| - | GA | |
| General Practice, Family Practice | SC | |
| Nurse Practitioner | GA |
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