MEDICARE: DR. RICKIE WADE ELLIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	200101442	NC

General Provider Information

NPI Number	:	1831129220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICKIE WADE ELLIS M.D.

Provider Business Mailing Address
First Line	:	4300 SAPPHIRE CT STE 110
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-9079
Country	:	US
Telephone Number	:	252-830-7561
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 S QUEEN ST
Second Line	:
City	:	KINSTON
State	:	NC
Zip	:	28501-4933
Country	:	US
Telephone Number	:	252-522-9800
Fax Number	:	252-523-9790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	11/28/2022

Similar Medicare Providers

1578849857 — BRANDY HARRELL LCAS
Practice Location Address:

107 S QUEEN ST
KINSTON, NC
28501-4933

Practice Phone: 252-522-9800
Practice Fax: 252-523-9790

1972550325 — AQILAH TALIB BATTLE MSW, LCSW
Practice Location Address:

107 S QUEEN ST
KINSTON, NC
28501-4933

Practice Phone: 252-522-9800
Practice Fax: 252-523-9790

1811134422 — COMPREHENSIVE SOLUTIONS OF NORTH CAROLINA, INC.
Practice Location Address:

121 S QUEEN ST
KINSTON, NC
28501-4933

Practice Phone: 252-523-2600
Practice Fax: 252-523-2609

1003336793 — TAYLOR JOHNSON MSW, LCSWA
Practice Location Address:

121 S QUEEN ST
KINSTON, NC
28501-4933

Practice Phone: 919-816-2712
Practice Fax:

1891486775 — MRS. LAURA LEE ANTHONY NP
Practice Location Address:

100 AIRPORT RD FL 4
KINSTON, NC
28501-1604

Practice Phone: 252-522-7197
Practice Fax: 252-522-7250

1144950791 — SIJAN KHATIWADA MD
Practice Location Address:

100 AIRPORT RD
KINSTON, NC
28501-1604

Practice Phone: 252-522-7000
Practice Fax:

Directions to “ DR. RICKIE WADE ELLIS M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.