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

Ryan Scott Ellsworth, DPM

Individual provider Podiatrist · NPI 1104130574

Ryan Scott Ellsworth, DPM is a Podiatry in Atlanta, Georgia. Qualified in 2010, 16 years ago. Practices as a sole proprietor and works from 10 locations. Licensed in California, Florida, Georgia and Nevada and 1 more.

Years since qualifying
16
Licensed in
CA, FL, GA, NV, UT
In the registry since
2010
Specialties on file
9
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

505 Fairburn Rd SW Ste 100
Atlanta, GA 30331-2012
Phone: (404) 618-6077
Fax: (801) 253-6888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (9)

  • 12780 Race Track Rd Ste 417, Tampa, FL 33626-1395 — (813) 535-7707
  • 95 White Sage Ave Ste C, Delta, UT 84624-5555 — (801) 253-6886
  • 770 S Highway 99, Fillmore, UT 84631-5033 — (801) 253-6886
  • 227 N Westwood Blvd, Price, UT 84501-5500 — (801) 253-6886
  • 3355 N University Ave Ste 175, Provo, UT 84604-6620 — (801) 253-6886
  • 4019 W 12600 S, Riverton, UT 84096 — (801) 253-6886
  • 12523 S Creek Meadow Rd Ste 105, Riverton, UT 84065-7299 — (801) 253-6886
  • 3130 S Highland Dr Ste B4, Salt Lake City, UT 84106-3095 — (801) 253-6886
  • 2019 E Riverside Dr Ste A101, St George, UT 84790-8147 — (801) 253-6886

Specialties & licences

Foot Surgery Podiatrist (primary) Taxonomy 213ES0131X · Licence 8400193-0501 (UT)
Podiatrist Taxonomy 213E00000X · Licence 2109 (NV)
Podiatrist Taxonomy 213E00000X · Licence E5797 (CA)
Podiatrist Taxonomy 213E00000X · Licence PO4406 (FL)
Podiatrist Taxonomy 213E00000X · Licence POD001473 (GA)
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X · Licence 8400193-0501 (UT)
Radiology Podiatrist Taxonomy 213ER0200X · Licence 8400193-0501 (UT)
Sports Medicine Podiatrist Taxonomy 213ES0000X · Licence 8400193-0501 (UT)
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X · Licence 8400193-0501 (UT)

Record details

NPI number1104130574
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedJuly 28, 2010
Last updated in NPPESJune 17, 2024
Certification dateJune 17, 2024
Mailing address9980 S 300 W Ste 300, Sandy, UT 84070-3654

Medicare enrollment

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

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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