Active NPI
Savannah Ellis, CPT, CCMA
- Phlebology Physician
- O Fallon, MO
National Provider Identifier
1225946221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- J2R9P6C2
- Practice address
- 300 Stonewall Creek Dr
O Fallon, MO 63368-7591 - Phone
- (636) 293-7302
- NPI assigned
- Aug 31, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | J2R9P6C2 | MO | |
| Phlebology Physician | 202K00000X | J2R9P6C2 | MO | Primary |
Addresses
Primary practice location
300 Stonewall Creek Dr
O Fallon, MO 63368-7591
Mailing address
300 Stonewall Creek Dr
O Fallon, MO 63368-7591
Phone (636) 293-7302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1225946221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 STONEWALL CREEK DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633687591",
"telephone_number": "636-293-7302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 STONEWALL CREEK DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633687591",
"telephone_number": "636-293-7302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SAVANNAH",
"credential": "CPT, CCMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-08-31",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "MO",
"license": "J2R9P6C2",
"primary": false
},
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "MO",
"license": "J2R9P6C2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.