Dr Randall E Ellis, MD - Medicare Emergency Medicine in Clarksville, TN

Dr Randall E Ellis, MD is a medicare enrolled "Emergency Medicine" physician in Clarksville, Tennessee. He went to Vanderbilt University School Of Medicine and graduated in 1989 and has 35 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice San Carlos Apache Healthcare Corporation and his current practice location is 2320 Wilma Rudolph Blvd, Clarksville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (931) 645-1564.

Dr Randall E Ellis is licensed to practice in Tennessee (license number MD27444) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1396784138.

Contact Information

Dr Randall E Ellis, MD
2320 Wilma Rudolph Blvd,
Clarksville, TN 37040-5821
(931) 645-1564
(931) 645-3842



Physician's Profile

Full NameDr Randall E Ellis
GenderMale
SpecialityEmergency Medicine
Experience35 Years
Location2320 Wilma Rudolph Blvd, Clarksville, Tennessee
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Randall E Ellis attended and graduated from Vanderbilt University School Of Medicine in 1989
  NPI Data:
  • NPI Number: 1396784138
  • Provider Enumeration Date: 06/06/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 3779476403
  • Enrollment ID: I20221219002921

Medical Identifiers

Medical identifiers for Dr Randall E Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396784138NPI-NPPES
4041098OtherTNBLUECROSS BLUESHIELD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine MD27444 (Tennessee)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
San Carlos Apache Healthcare Corporation0648580597112

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Randall E Ellis allows following entities to bill medicare on his behalf.
Entity NameSan Carlos Apache Healthcare Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265813075
PECOS PAC ID: 0648580597
Enrollment ID: O20151105002091

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Randall E Ellis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Randall E Ellis, MD
2320 Wilma Rudolph Blvd,
Clarksville, TN 37040-5821

Ph: (931) 645-1564
Dr Randall E Ellis, MD
2320 Wilma Rudolph Blvd,
Clarksville, TN 37040-5821

Ph: (931) 645-1564

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Emergency Medicine Doctors in Clarksville, TN

John D Shields, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1771 Madison St, Clarksville, TN 37043
Phone: 931-552-6622    
Dr. Malcolm A Steele, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 651 Dunlop Ln, Clarksville, TN 37040
Phone: 931-502-1370    
Manickam Krishnamurthy, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 651 Dunlop Ln, Clarksville, TN 37040
Phone: 931-502-1370    
Mark A Muiznieks, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 651 Dunlop Lane Clarksville, Clarksville, TN 37040
Phone: 931-502-1370    
Dr. Russell Paul Landry Iii, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 651 Dunlop Lane, Clarksville, TN 37040
Phone: 713-430-6095    
Dr. Timothy L Obernuefemann, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 2320 Wilma Rudolph Blvd, Clarksville, TN 37040
Phone: 931-645-1564    Fax: 931-645-3842
Dr. James Willis Hickerson Jr., MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 651 Dunlop Ln, Clarksville, TN 37040
Phone: 931-502-1370    

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