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

MS. Heather Renee Ellis, PA-C

Individual provider Physician Assistant · NPI 1356026157

MS. Heather Renee Ellis, PA-C is a Physician Assistant in Bristol, Tennessee. Qualified in 2023, 3 years ago. Works from 2 locations. Licensed in Tennessee.

Years since qualifying
3
Licensed in
TN
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone: (423) 844-1121
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 800 S Mohawk Dr Ste C, Erwin, TN 37650-2124 — (423) 735-4750

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5557 (TN)

Record details

NPI number1356026157
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 19, 2023
Last updated in NPPESOctober 14, 2025
Certification dateOctober 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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