Jack Ellis, D.O.
Jack Ellis, D.O. is an Internal Medicine Physician in Augusta, GA, registered under NPI 1003115254. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
Here is what surrounds this office in Augusta, based on OpenStreetMap data collected Aug 29, 2026. Parking is available about 827 ft away. A pharmacy sits 0.33 mi from the entrance (CVS Pharmacy), which helps if you leave with a prescription. If you arrive early, there is a coffee shop 0.38 mi away.
Getting here and what is nearby
Parking 584 ft ~3 min
Parking Goss Lane Parking Deck (CP)- Parking #04 731 ft ~3 min
Parking 827 ft ~4 min
Gas station Shell 973 ft ~4 min
Hotel Econo Lodge Downtown 1,003 ft ~4 min
1103 15th Street, Augusta 30901
Pharmacy CVS Pharmacy 0.33 mi ~7 min
Restaurant McDonald's 0.33 mi ~7 min
Restaurant Firehouse Subs 0.37 mi ~8 min
1509 Walton Way
Coffee Starbucks 0.38 mi ~8 min
Restaurant Bojangles' 0.40 mi ~8 min
Distances are straight‑line estimates — walking routes may be longer. Hours and phone numbers can change; call ahead to confirm.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 072627 | GA | Internal Medicine Physician primary |
This provider holds licence 072627 issued in GA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Internal Medicine
- PAC ID
- 8729209903
- Enrollment ID
- I20150317001692
Medicare enrolment is recorded as approved under the provider type Practitioner - Internal Medicine. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Internal Medicine covers
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. NUCC Health Care Provider Taxonomy, code 207R00000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | |
| 207R00000X | Internal Medicine Physician | 072627 | GA | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1003115254 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 26, 2011 |
| Last updated | May 31, 2018 |
| Status | Active |
| Sole proprietor | No |
| Gender | Male |
| Credential | D.O. |
| Practice address |
1120 15TH ST Augusta, GA 30912 (706) 721-8623 |
| Mailing address |
1499 WALTON WAY STE 1400 Augusta, GA 30901 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 0 | 3 | 1 | 1 | 5 | 2 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 0 | 3 | 2 | 1 | 1 | 2 | 1 |
Sum = 36 · next multiple of 10 = 40 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.