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

Stephen Thomas Ellis

Individual provider Physician Assistant · NPI 1013733575

Stephen Thomas Ellis is a Physician Assistant in Holly Springs, Georgia. Qualified in 2025, 1 year ago. Registered with an NPI since 2024.

Years since qualifying
1
In the registry since
2024

Practice location Address checks out

100 Holly Park Ct Apt 6308
Holly Springs, GA 30115-0226
Phone: (770) 380-2334
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1013733575
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 2, 2024
Last updated in NPPESDecember 2, 2024
Certification dateDecember 1, 2024
Mailing address100 Holly Park Ct Apt 6308, Holly Springs, GA 30115-0226

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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