Shannon Marie Ellis

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34010495A Issued in IN

Practice address

2814 Amherst St
Indianapolis, IN 46268-1266

Phone

(317) 914-3408

NPI assigned

Mar 13, 2023

Last updated

Sep 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shannon.ellis.1@27775.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cityblock Medical Practice, P.a.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1588296784

  IL

  Medicare reassignment NPD
• Carmel Therapy LLC

  dba Carmel Therapy Network

  • Mental Health Counselor
  • Pendleton, IN
  • NPI 1386345957
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1215638622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 AMHERST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681266",
            "telephone_number": "317-914-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 AMHERST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681266",
            "telephone_number": "317-914-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010495A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Annette Ellis
• Kayla Ellis, MD
• Pamela Sue Ellis, RPH
• Ryan Joseph Ellis, MD
• Shaneise Ellis, MD, MBA
• Shaquona Ellis
• Teylor N Ellis, PA-C
• Wayne M. Ellis, MD
• Kaysee Mae Ellrich, OTR
• Cierra Ellson

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.