IRA KEITH ELLIS (MD) – Addiction Medicine (Family Medicine) Physician, NPI 1922005388

IRA KEITH ELLIS (MD) is a healthcare provider. based in Jackson, Tennessee. specializing in FAMILY PRACTICE, ADDICTION MEDICINE. They hold the professional credentials MD. They hold a License No. 38294 (TN). The NPI Number for IRA KEITH ELLIS (MD) is 1922005388

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
IRA KEITH ELLIS (MD)
NPI
1922005388
Phone
(731) 423-1932
Address
294 SUMMAR DR
Enumeration Date
30 June 2005
Last Update Date
10 January 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
7312656025
Graduation Year
2002 (24 years ago)
PAC ID
5496734766
Group Practice PAC ID
5991065427
Professional Enrollment ID
I20040719001453
Address ID
TN383052089JA37XXXCIRX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,210 FAMILY PRACTICE in TN

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Provider Addresses for IRA KEITH ELLIS (MD)

  • Summar Drive, Westwood Gardens, Jackson, Madison County, Tennessee, 38301, United States

    DEPT 289

    JACKSON, TN 383013915

    Phone: (731) 423-1932

    Fax: (731) 410-0367

    Type: Mailing

  • West Main Street, Milan, Carmi, White County, Illinois, 62821, United States

    MILAN, TN 383583515

    Phone: (615) 673-6737

    Type: Location

  • 73 White Bridge Rd # 103-243

    Nashville, TN 372051444

    Phone: (731) 423-1932

    Fax: (731) 423-4919

    Type: Location

  • 3074 Creswell St

    Milan, TN 383583500

    Phone: (615) 673-6737

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $100.

Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: Indivior Inc. ($44).

Total Amount

$100

General + Research + Ownership

Payments

5

Total payment records

General Amount

$100

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-07-19

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
I20040719001453IFamily PracticeTNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes10920$0
80305Testing for presence of drug, read by direct observation9219$0
G2087Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month7515$0
99484Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional4316$0
View full utilization report →

Insurance plans in this area (ZIP 38301)

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Provider's Procedures

IRA KEITH ELLIS (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINETN93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report3425

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: 5991065427View full group profile
NameSpecialtyState
-TN
Internal Medicine, Addiction MedicineTN
Addiction Medicine, Family PracticeTN
Nurse PractitionerTN
Nurse PractitionerMS
-TN
Nurse PractitionerTN

Reviews

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Frequently asked questions

How do payers reference IRA KEITH ELLIS (MD)?
For IRA KEITH ELLIS (MD), use NPI 1922005388 as the unique 10-digit identifier.
Is there an active status for IRA KEITH ELLIS (MD)?
For scheduling context, IRA KEITH ELLIS (MD) is shown as active in the registry.
What expertise is attributed to IRA KEITH ELLIS (MD)?
IRA KEITH ELLIS (MD)'s specialty line reads Addiction Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is IRA KEITH ELLIS (MD) located near Jackson?
IRA KEITH ELLIS (MD) currently maps to Jackson, Tennessee in this extract.
Does IRA KEITH ELLIS (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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