Cortney Shantres Ellis, | |
110 Evans Dr, Belton, SC 29627-9464 | |
(864) 356-4598 | |
Not Available |
Full Name | Cortney Shantres Ellis |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 110 Evans Dr, Belton, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396380283 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 23492 (South Carolina) | Secondary |
363LF0000X | Nurse Practitioner - Family | 2019050719 (South Carolina) | Primary |
Entity Name | Healthworks Med Group Of South Carolina, P.c |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588972426 PECOS PAC ID: 2466620034 Enrollment ID: O20110726000548 |
Entity Name | David Budhoo Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881110294 PECOS PAC ID: 5496088684 Enrollment ID: O20190603001233 |
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191209002986 |
Mailing Address | Practice Location Address |
---|---|
Cortney Shantres Ellis, 300 Brittany Park, Anderson, SC 29621-1565 Ph: (864) 356-4598 | Cortney Shantres Ellis, 110 Evans Dr, Belton, SC 29627-9464 Ph: (864) 356-4598 |
Carolyn Blanche Mega, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 113 Wildwood Dr, Belton, SC 29627 Phone: 864-940-9701 Fax: 864-338-8760 | |
Candace Jones, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 Running Fox Ln, Belton, SC 29627 Phone: 864-940-8530 |