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

Kylie Alyssa Ellis, APRN

Individual provider Registered Nurse · NPI 1457984361

Kylie Alyssa Ellis, APRN is a Nurse Practitioner in Newnan, Georgia. Qualified in 2021, 5 years ago. Practices with Intermountain Medical Group Grand Junction, LLC, a 299-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2020
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

795 Poplar Rd Ste 400
Newnan, GA 30265-2590
Phone: (770) 716-0051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6507 Professional Pl, Riverdale, GA 30274-4941 — (404) 251-2850

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence RN239284 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN239284 (GA)

Record details

NPI number1457984361
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedFebruary 19, 2020
Last updated in NPPESOctober 20, 2022
Certification dateOctober 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Intermountain Medical Group Grand Junction, Llc — 299 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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