Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kenneth Ray Ellis, MA

Individual provider Specialist · NPI 1700103934

Kenneth Ray Ellis, MA is a Specialist in Johnson City, Tennessee. Practices as a sole proprietor. Registered with an NPI since 2010.

In the registry since
2010
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

2243 Eddie Williams Rd
Johnson City, TN 37601-2872
Phone: (423) 928-5627
Fax: (423) 467-3644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1700103934
Entity typeIndividual (Type 1)
GenderMale
Credentials MA
Sole proprietorYes
NPI enumeratedApril 28, 2010
Last updated in NPPESApril 28, 2010
Mailing address1167 Spratlin Park Dr, Gray, TN 37615-6205

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