IRA KEITH ELLIS (MD) – Addiction Medicine (Family Medicine) Physician, NPI 1922005388
Addiction Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
| Company | Amount |
|---|---|
| Indivior Inc. | $44 |
| ABBVIE INC. | $37 |
| Braeburn Inc. | $19 |
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040719001453 | I | Family Practice | TN | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 109 | 20 | $0 |
| 80305 | Testing for presence of drug, read by direct observation | 92 | 19 | $0 |
| G2087 | Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month | 75 | 15 | $0 |
| 99484 | Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional | 43 | 16 | $0 |
Insurance plans in this area (ZIP 38301)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| EMERGENCY MEDICINE | TN | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 34 | 25 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| Internal Medicine, Addiction Medicine | TN | |
| Addiction Medicine, Family Practice | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | MS | |
| - | TN | |
| Nurse Practitioner | TN |
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