Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Robert Ellis Jr., PA-C

Individual provider Medical Physician Assistant · NPI 1780278499

Robert Ellis Jr., PA-C is a Physician Assistant in Memphis, Tennessee. Qualified in 2020, 6 years ago. Practices with Baptist Memorial Medical Group, Inc, a 571-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Mississippi and Tennessee.

Years since qualifying
6
Licensed in
MS, TN
In the registry since
2021
Specialties on file
3
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

6025 Walnut Grove Rd Ste 301
Memphis, TN 38120-2123
Phone: (901) 226-0456
Fax: (901) 226-0458
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 363 Southcrest Cir Ste 202, Southaven, MS 38671-4737 — (901) 226-0456
  • 8138 Country Village Dr, Cordova, TN 38016-2029 — (901) 725-8606
  • 2100 Exeter Rd, Germantown, TN 38138-3966 — (901) 757-1350

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5490 (TN)
Medical Physician Assistant Taxonomy 363AM0700X
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA00540 (MS)

Record details

NPI number1780278499
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 23, 2021
Last updated in NPPESFebruary 24, 2025
Certification dateFebruary 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Baptist Memorial Medical Group, Inc. — 571 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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