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

Individual provider Speech-Language Pathologist · NPI 1194565978

Suzanne Ivie Ellis is a Qualified Speech Language Pathologist in Smyrna, Georgia. Qualified in 2024, 2 years ago. Practices with Legacy Healthcare Services Inc, a 3,624-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
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Practice location Address checks out

4005 S Cobb Dr SE
Smyrna, GA 30080-6307
Phone: (770) 431-7055
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X (GA)

Record details

NPI number1194565978
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 29, 2024
Last updated in NPPESMay 29, 2024
Certification dateMay 29, 2024
Mailing address4005 S Cobb Dr Se, Smyrna, GA 30080-6307

Medicare enrollment

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

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Legacy Healthcare Services Inc — 3624 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Smyrna