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

Mr. Justin D. Ellis, PA

Individual provider Physician Assistant · NPI 1972566651

Mr. Justin D. Ellis, PA is a Physician Assistant in Hickory, North Carolina. Qualified in 1999, 27 years ago. Practices with Catawba Valley Medical Group Inc, a 134-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
27
Licensed in
NC
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1771 Tate Blvd SE Ste 201
Hickory, NC 28602-4249
Phone: (828) 324-4804
Fax: (828) 324-7256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 102909 (NC)

Record details

NPI number1972566651
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 11, 2006
Last updated in NPPESJune 3, 2015

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Catawba Valley Medical Group Inc — 134 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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