Dr Shannon Bolling Ellis, DO - Medicare Preventive Medicine in Savannah, GA

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Dr Shannon Bolling Ellis, DO is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Savannah, Georgia. His current practice location is 400 Mall Blvd Ste G, Savannah, Georgia. You can reach out to his office (for appointments etc.) via phone at (912) 644-5200.

Dr Shannon Bolling Ellis is licensed to practice in Georgia (license number 073702) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1295706166.

Contact Information

Dr Shannon Bolling Ellis, DO
400 Mall Blvd Ste G,
Savannah, GA 31406-4820
(912) 644-5200
(912) 349-5691

Map and Direction




Physician's Profile

Full NameDr Shannon Bolling Ellis
GenderMale
SpecialityPreventive Medicine - Public Health & General Preventive Medicine
Location400 Mall Blvd Ste G, Savannah, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1295706166
  • Provider Enumeration Date: 01/30/2006
  • Last Update Date: 01/25/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 7113116070
  • Enrollment ID: I20110106001192

Medical Identifiers

Medical identifiers for Dr Shannon Bolling Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295706166NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2083P0901XPreventive Medicine - Public Health & General Preventive Medicine 073702 (Georgia)Primary

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 Shannon Bolling Ellis allows following entities to bill medicare on his behalf.
Entity NameLiberty County Board Of Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245546704
PECOS PAC ID: 6204724420
Enrollment ID: O20040309000899
Entity NameGlynn County Board Of Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164429692
PECOS PAC ID: 4385532456
Enrollment ID: O20040309001226
Entity NameChatham County Board Of Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164503124
PECOS PAC ID: 1658367727
Enrollment ID: O20040423000125

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 Shannon Bolling 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 Shannon Bolling Ellis, DO
815 Oak Landing Rd,
Jesup, GA 31546-1518

Ph: (912) 424-2925		Dr Shannon Bolling Ellis, DO
400 Mall Blvd Ste G,
Savannah, GA 31406-4820

Ph: (912) 644-5200

Reviews and Comments


Preventive Medicine Doctors in Savannah, GA

John Davidson Carson, M.D.
Preventive Medicine
Medicare: Medicare Enrolled
Practice Location: 318 Mall Blvd Ste 300b, Savannah, GA 31406
Phone: 912-358-1515    Fax: 912-480-0505
Dr. George Gilbert Haberman, M.D.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 1903 Abercorn St, Savannah, GA 31401
Phone: 912-232-5169    Fax: 912-232-0048
Dr. Robert Koji Russell, D.O.
Preventive Medicine
Medicare: Medicare Enrolled
Practice Location: 5002 Waters Ave, Savannah, GA 31404
Phone: 912-355-0070    
Neil F Gordon, M.D.
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5356 Reynolds St, Suite 102, Savannah, GA 31405
Phone: 912-819-4355    Fax: 912-819-5292
Calayia Oliver,
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 7331 Albert St, Savannah, GA 31406
Phone: 912-228-2794    
Robert S Balsley, MD
Preventive Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 14089 Abercorn St, Savannah, GA 31419
Phone: 912-350-2121    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.