DR. SHANNON BOLLING ELLIS D.O. NPI 1295706166

NPI Information

  • NPI: 1295706166
  • Provider Name: DR. SHANNON BOLLING ELLIS, D.O.
  • Classification: Preventive Medicine - 2083P0901X
  • Specialization: Public Health & General Preventive Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 400 MALL BLVD STE G
    SAVANNAH, GA
    ZIP 31406
  • Phone: (912) 644-5200

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NPI Details

DR. Shannon Bolling Ellis, D.O. is a public health and general preventive medicine preventive medicine in Savannah, GA. The provider is 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. DR. Shannon Bolling Ellis, D.O. NPI is 1295706166. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

400 MALL BLVD STE G
SAVANNAH, GA
ZIP 31406-820
Phone: (912) 644-5200
Fax: (912) 349-5691

The NPI 1295706166 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/30/2006 and was last updated on 1/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083P0901XPreventive MedicinePublic Health & General Preventive Medicine073702GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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