Active NPI
Shana B Ellis, CRNP
- Family Nurse Practitioner
- Ringgold, GA
National Provider Identifier
1164938544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-145902
- Practice address
- 4083 Cloud Springs Rd
Ringgold, GA 30736-8411 - Phone
- (706) 820-6143
- Fax
- (706) 956-8171
- NPI assigned
- Dec 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-145902 | AL | Primary |
Addresses
Primary practice location
4083 Cloud Springs Rd
Ringgold, GA 30736-8411
Mailing address
5086 Al Highway 73
Bryant, AL 35958-4316
Other names 1
- Shana M White
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Treatment Center of Calhoun, PC | Current | Accepting new patients | |
| Crossroads Treatment Center of Northwest Georgia | Current | Accepting new patients |
Locations
367 Richardson Rd SE
Calhoun, GA 30701
Phone (762) 204-2451
4083 Cloud Springs Rd
Ringgold, GA 30736
Phone (706) 820-6087
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Harriman, TN
- NPI 1316403405
-
- Methadone Clinic
- Calhoun, GA
- NPI 1932626892
-
- Community/Behavioral Health Agency
- Ringgold, GA
- NPI 1356799688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1164938544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5086 AL HIGHWAY 73",
"city": "BRYANT",
"state": "AL",
"postal_code": "359584316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4083 CLOUD SPRINGS RD",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307368411",
"telephone_number": "706-820-6143",
"fax_number": "706-956-8171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SHANA",
"middle_name": "B",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-145902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANA",
"last_name": "WHITE",
"middle_name": "M",
"credential": "CRNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ringgold, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.