SHAWN ELLIS (NPI# 1700025244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700025244 |
| Entity Type | Individual |
| Full Name | SHAWN ELLIS |
| Practice Address |
3533 Southern Blvd Ste 5650 Kettering OH 45429-1264 |
| Practice Telephone | 9372943611 |
| Practice Fax Number | 9372949010 |
| Mailing Telephone | 9372943611 |
| Mailing Fax Number | 9372949010 |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | 060010 | OH | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851551790 | Shawn Michael Ellis | Anesthesiology | 4345 W Memorial Rd Ste 110, Oklahoma City, OK 73134-1717 | 2008-06-13 |
| Street Address |
3533 SOUTHERN BLVD STE 5650 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630137 | V. Joseph Karnitis | Obstetrics & Gynecology | 3533 Southern Blvd, Suite 4100, Kettering, OH 45429-1264 | 2005-06-24 |
| 1881208346 | Alexander John Armstrong | Physician Assistant | 3533 Southern Blvd, Kettering, OH 45429-1264 | 2020-09-02 |
| 1740739051 | Angela Yost | Nurse Practitioner | 3533 Southern Blvd, Suite 5350, Kettering, OH 45429-1264 | 2016-09-27 |
| 1215385968 | Angela Ponder | Dietitian, Registered | 3533 Southern Blvd, Suite 3750, Kettering, OH 45429-1264 | 2016-06-02 |
| 1992175798 | Megan Haas | Physician Assistant | 3533 Southern Blvd, Suite 5650, Kettering, OH 45429-1264 | 2015-10-06 |
| 1578931564 | Brian Wesche | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1932577012 | Brooke Marie Obrien | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-09-08 |
| 1841682499 | Keith A Rooker | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Ste 400, Kettering, OH 45429-1264 | 2015-02-19 |
| 1770972804 | Kristen Roth | Nurse Anesthetist, Certified Registered | 3533 Southern Blvd, Suite 3400, Kettering, OH 45429-1264 | 2015-01-13 |
| 1841600574 | Riyad J Tayim | Surgery | 3533 Southern Blvd, Ste 2250, Kettering, OH 45429-1270 | 2014-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841603735 | James Pitcher | Perfusionist | 3533 Southern Blvd Ste 5650, Kettering, OH 45429-1263 | 2014-06-09 |
| 1447551296 | Chad Svaranowic | Perfusionist | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2010-11-10 |
| 1548400880 | Sharon Halter | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2009-02-26 |
| 1265672505 | Douglas Tidwell | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2009-02-26 |
| 1457590994 | Mark Nelson | Perfusionist | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2009-02-06 |
| 1710126255 | Brian Crawford | Perfusionist | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2009-02-06 |
| 1275772717 | Kenneth Gill | Perfusionist | 3533 Southern Blvd, Ste 5650, Kettering, OH 45429-1264 | 2009-02-06 |
| 1306091350 | Aaron Joseph Siefker | Perfusionist | 580 Lincoln Park Blvd, Suite 322, Kettering, OH 45429-3474 | 2008-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225456494 | Majdi Mojahed | Perfusionist | 1386 Powersdale Ave, Youngstown, OH 44502-2154 | 2014-04-03 |
| 1598967663 | William Anthony Mervar | Perfusionist | 15849 Arbor Trl, Newbury, OH 44065-9100 | 2007-06-01 |
| 1760019483 | Mark Mckinney | Perfusionist | 1520 S Main St Ste 3, Dayton, OH 45409-2643 | 2020-03-24 |
| 1578903209 | Mark James Burger | Perfusionist | 1520 S Main St, Suite 3, Dayton, OH 45409-2698 | 2013-06-26 |
| 1821305202 | Krystle Kulon | Perfusionist | 6780 Mayfield Rd, Mayfield Hts, OH 44124-2203 | 2010-09-08 |
| 1336374859 | Mark E Mccloskey | Perfusionist | 2200 Philadelphia Dr, Suite 555, Dayton, OH 45406-1840 | 2009-05-28 |
| 1194967638 | Scott M Turner | Perfusionist | 30 E Apple St Ste 6252, Dayton, OH 45409-2939 | 2009-03-30 |
| 1255573788 | Marian F Hull | Perfusionist | 30 E Apple St Ste 6252, Dayton, OH 45409-2939 | 2009-03-30 |
| 1679715114 | Greg Alan Grant | Perfusionist | 30 E Apple St Ste 6252, Dayton, OH 45409-2939 | 2009-03-30 |
| 1164662417 | Angela Susanne Hoefler | Perfusionist | 2200 Philadelphia Dr, Suite 301, Dayton, OH 45406-1840 | 2009-02-26 |
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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.