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DR. SHANNON BOLLING ELLIS D.O.
NPI 1295706166
Preventive Medicine - Public Health & General Preventive Medicine in Savannah, GA

Active since January 30, 2006PECOS Enrolled
400 MALL BLVD STE G, SAVANNAH, GA 31406(912) 644-5200(912) 349-5691 Get Directions Write a Review

NPPES record last updated: January 25, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 25, 2021, Feb 27, 2017 (2 updates tracked since 2017).

About Dr. Shannon Bolling Ellis D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANNON BOLLING ELLIS D.O. (NPI 1295706166) is an individual public health & general preventive medicine provider in Savannah, Georgia, licensed in Georgia (073702) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1295706166
Entity TypeIndividualMale
Primary Taxonomy2083P0901X
Provider Legal NameDR. SHANNON BOLLING ELLISCredential: D.O.
Location Address400 MALL BLVD STE GSavannah, GA 31406-4820
Mailing Address815 Oak Landing RdJesup, GA 31546-1518 · (912) 424-2925
Phone(912) 644-5200
Fax(912) 349-5691
Sole ProprietorNo
Enumeration DateJanuary 30, 2006
Last NPPES UpdateJanuary 25, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2021
✔ NPI 1295706166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPreventive Medicine · Public Health & General Preventive MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0901X
License✔ Licensed in GA · 073702
Definition
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.
400 MALL BLVD STE G, Savannah, GA 31406
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shannon Bolling Ellis D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shannon Ellis reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Chatham County Board Of Health
4.0 mi
Public Health or Welfare
1602 DRAYTON ST
Savannah, GA 31401
  • Reassigned Medicare billing, Georgia enrollment
  • 13 clinicians in this Medicare group
NPI 1578644522 (912) 262-2347
Glynn County Board Of Health
61 mi
Public Health or Welfare
2747 4TH ST
Brunswick, GA 31520
  • Reassigned Medicare billing, Georgia enrollment
  • 15 clinicians in this Medicare group
NPI 1164429692 (912) 264-3236

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31406 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Ellis's NPI number?

The NPI number for Shannon Ellis is 1295706166. It was assigned to this individual provider in the NPPES registry on January 30, 2006.

Where is Shannon Ellis located?

Shannon Ellis practices at 400 Mall Blvd Ste G, Savannah, GA 31406. The listed phone number is (912) 644-5200.

What is Shannon Ellis's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Public Health & General Preventive Medicine, with taxonomy code 2083P0901X.

Is Shannon Ellis enrolled in Medicare?

Yes. Shannon Ellis is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shannon Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Ellis reassigns Medicare benefits to 2 organizations: Chatham County Board Of Health (Savannah, GA) and Glynn County Board Of Health (Brunswick, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shannon Ellis was last updated on January 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.