Carolyn Ellis
NPI 1104291533ActiveIndividual· Physician Assistant, Medical· Dickson, TN
Physician Assistant, Medical in Dickson, Tennessee, licensed in TN and AL, with an NPI issued in December 2015. 122 Medicare patients in 2024, $12,010 paid; nearly all of their 143 Part D prescriptions were generic (95%).
Overview
| NPI | 1104291533 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Dec 10, 2015 |
| Last updated in NPPES | Dec 10, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | 2879 | TN |
| Physician Assistant, Medical | 363AM0700X | 1087 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 122 |
|---|---|
| Services billed | 146 across 15 procedure codes |
| Paid by Medicare | $12,010 |
Part D prescriptions in 2024
| Prescriptions (claims) | 143 · 143 30-day fills |
|---|---|
| Patients | 102 |
| Total drug cost | $877.88 |
| Generic share | 95% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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