DR. SHANNON BOLLING ELLIS (NPI# 1295706166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295706166 |
| Entity Type | Individual |
| Full Name | DR. SHANNON BOLLING ELLIS |
| Credential | D.O. |
| Practice Address |
2600 Hwy 301s Jesup GA 31599-5641 |
| Mailing Address |
815 Oak Landing Rd Jesup GA 31546-1518 |
| Practice Telephone | 9124270870 |
| Mailing Telephone | 9124242925 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2017-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
073702 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750989356 | Shannon Rose Ellis | Nurse Practitioner | 1460 Fairway Oaks Dr, Casselberry, FL 32707-5140 | 2020-10-15 |
| 1487165858 | Shannon Noel Ellis | Counselor | 48 Private Drive 339, South Point, OH 45680-8919 | 2017-10-12 |
| 1841848678 | Shannon M Ellis | Physician Assistant | 125 Fox Hollow Rd Ste 210, Pinehurst, NC 28374-8593 | 2019-08-26 |
| 1033606116 | Shannon Ellis | Behavior Technician | 515 Palm Coast Pkwy Sw, Palm Coast, FL 32137-4739 | 2018-04-15 |
| 1710359849 | Shannon Ellis | Nurse Practitioner | 2235 Lake Heights Dr, Everett, WA 98208-6030 | 2015-10-28 |
| 1568867430 | Shannon M Ellis | Physical Therapy Assistant | 5775 Old Winder Hwy, Braselton, GA 30517-1603 | 2014-11-04 |
| 1245644632 | Shannon Ellis | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2014-06-13 |
| 1710322805 | Shannon Hope Ellis | Social Worker | 2140 E Ellsworth Rd, Ann Arbor, MI 48108-2552 | 2013-05-03 |
| 1124219563 | Shannon Scott Ellis | Family Medicine | 26 W Jackson Commons Dr, Hoschton, GA 30548-1897 | 2007-08-08 |
| 1740483734 | Shannon B Ellis | Obstetrics & Gynecology | 800 Saint Vincents Dr, Suite 500, North Tower, Birmingham, AL 35205-1620 | 2007-06-07 |
| Street Address |
2600 HWY 301S |
| City | JESUP |
| State | GA |
| Zip Code | 31599-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598084311 | Nina Leah Watson | Pharmacist | 2600 Hwy 301 S, Jesup, GA 31599-0001 | 2010-05-18 |
| 1205043288 | Bolaji Aremu | Physician Assistant | Fci, 2600 Hwy 301 South, Jesup, GA 31599-0001 | 2007-05-17 |
| 1538291067 | William Frederic Corey | Psychologist | Psychology Services Dept, 2600 Hwy 301 South, Jesup, GA 31599-0001 | 2007-03-11 |
| 1275938896 | Valerie Bagenski | Nurse Practitioner | 2600 Highway 301 S, Jesup, GA 31599-5676 | 2014-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1861018913 | Lavina Michelle Andrews | Occupational Therapy Assistant | 288 Osceola Trl N, Jesup, GA 31545-4853 | 2020-06-24 |
| 1720628019 | Savannah Grace Mcdaniel | Specialist/Technologist | 4046 Holmesville Rd, Jesup, GA 31545-2045 | 2020-01-14 |
| 1093350118 | Joseph Hires | Physical Therapist | 1064 N Macon St, Jesup, GA 31545 | 2019-11-13 |
| 1598300071 | Remeshia D Grant | Behavior Technician | 289 E Shellcracker Rd, Jesup, GA 31545-5667 | 2019-11-08 |
| 1003476128 | Ernest Knight Drugs, Inc | Pharmacy | 149 Nw Broad St, Jesup, GA 31545-1310 | 2019-06-20 |
| 1386201333 | People's Memorial Hospital | Family Medicine | 211 South Street West, Jesup, IA 50648 | 2019-05-24 |
| 1811459589 | Amber Michelle O'quinn | Specialist/Technologist | 250 Mellon St, Jesup, GA 31545-4716 | 2019-04-02 |
| 1881154045 | Hearts of Compassion Home Care Agency, Inc. | Religious Nonmedical Health Care Institution | 212 S 1st St Ste 4, Jesup, GA 31545-1137 | 2019-03-23 |
| 1952866279 | Scott's Transportation of Georgia, LLC | Non-emergency Medical Transport (VAN) | 3670 Waycross Hwy, Jesup, GA 31545 | 2019-02-01 |
| Find all providers in JESUP | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715137 | Ernest E Smith | Preventive Medicine | 115 W Dearborn Cir, Decatur, GA 30030-4474 | 2020-03-17 |
| 1033749288 | Atlanta Clinical Research Centers LLC | Preventive Medicine | 5673 Peachtree Dunwoody Rd Ste 440a, Atlanta, GA 30342-1797 | 2020-01-16 |
| 1316433105 | Thomas Boggs Richards | Preventive Medicine | 2067 Amberwood Way Ne, Atlanta, GA 30345-3903 | 2018-07-05 |
| 1871016592 | Sonja Suzzete Hutchins | Preventive Medicine | 435 Joseph E Lowery Blvd Sw, Atlanta, GA 30310-1471 | 2017-07-25 |
| 1922453547 | Passport Health Holdings, LLC | Preventive Medicine | 2470 Windy Hill Rd Se Ste 107, Marietta, GA 30067-8614 | 2016-05-02 |
| 1275988891 | Passport Health Holdings LLC | Preventive Medicine | 315 W Ponce De Leon Ave Ste 585, Decatur, GA 30030-2400 | 2016-05-02 |
| 1619336286 | Antonio Neri | Preventive Medicine | 1600 Clifton Rd Ne # Mse-92, Atlanta, GA 30329-4018 | 2016-02-11 |
| 1134597057 | Zachary Taylor IIi | Preventive Medicine | 1710 Whitehouse Ct, Dalton, GA 30720-8523 | 2015-09-09 |
| 1730557729 | Populations and Interventions Team Company (pitc) | Preventive Medicine | 3182 Berthas Overlook, Douglasville, GA 30135-8458 | 2015-09-08 |
| 1609252626 | Anthony Robbins | Preventive Medicine | 2707 Whispering Pines Ct, Decatur, GA 30033-1453 | 2015-07-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.