DR. MARK FREDERICK ELLISON M.D.
NPI 1265431092
Urology in Athens, GA

NPI Status: Active since July 14, 2005

Contact Information

2142 W BROAD ST
BUILDING 200, SUITE 200
ATHENS, GA
ZIP 30606
Phone: (706) 612-9401
Fax: (706) 612-9410

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  • Individual
  • Male
  • Urology

About MARK ELLISON

This page provides the complete NPI Profile along with additional information for Mark Ellison, a provider established in Athens, Georgia with a medical specialization in Urology. The healthcare provider is registered in the NPI registry with number 1265431092 assigned on July 2005. The practitioner's primary taxonomy code is 208800000X with license number 026107 (GA). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1265431092
Provider Name
DR. MARK FREDERICK ELLISON M.D.
Gender
Male
Entity Type
Individual
Location Address
2142 W BROAD ST BUILDING 200, SUITE 200 ATHENS, GA 30606
Location Phone
(706) 612-9401
Location Fax
(706) 612-9410
Mailing Address
PO BOX 6127 ATHENS, GA 30604
Mailing Phone
(706) 612-9401
Mailing Fax
(706) 612-9410
Is Sole Proprietor?
No
Enumeration Date
07-14-2005
Last Update Date
03-07-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Urology

Taxonomy Code
208800000X
Type
Allopathic & Osteopathic Physicians
License No.
026107
License State
GA
Taxonomy Description
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
000370994FMEDICAID (05)GA 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1265431092
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22125832018
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 2 + 5 + 8 + 3 + 2 + 0 + 1 + 8 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1265431092 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1073530937GNS,LLC
Organization
Neurological Surgery2142 W BROAD ST BLDG 100 SUITE 200
ATHENS, GA 30606
(706) 548-6881
1376747881 BOGDAN CRISTIAN JALIU MD
Individual
Physical Medicine & Rehabilitation (Pain Medicine)2142 W BROAD ST BLDG 100 STE 200
ATHENS, GA 30606
(706) 548-6881
1174768220MRS. DONNA BAGGETT MARTIN FNP-BC
Individual
Nurse Practitioner (Family)2142 W BROAD ST BLDG 100, STE 200
ATHENS, GA 30606
(706) 548-6881
1508135658SURGERY CENTER OF ATHENS LLC
Organization
Clinic/Center (Ambulatory Surgical)2142 W BROAD ST SUITE 100
ATHENS, GA 30606
(781) 733-2235
1659763035 JAIME BARRERA FNP-C
Individual
Nurse Practitioner (Family)2142 W BROAD ST BLDG 200 STE 200
ATHENS, GA 30606
(706) 612-9401
1770096034MS. RACHEL VICTORIA TREADWELL FNP-C
Individual
Nurse Practitioner (Family)2142 W BROAD ST
ATHENS, GA 30606
(706) 612-9401
1487826079 HARLAN JASON BRUNER M.D.
Individual
Neurological Surgery2142 W BROAD ST BUILDING 100, STE 200
ATHENS, GA 30606
(706) 548-6881
1760750137KAISER PERMANENTE
Organization
Clinical Medical Laboratory2142 W BROAD ST BLDG 200
ATHENS, GA 30606
(706) 583-5000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1265431092, enumerated in the NPI registry as an "individual" on July 14, 2005

The provider is located at 2142 W Broad St Building 200, Suite 200 Athens, Ga 30606 and the phone number is (706) 612-9401

The provider's speciality is Urology with taxonomy code 208800000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on July 14, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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