Active NPI
Shannon Ellis
- Contractor
- Maricopa, AZ
National Provider Identifier
1497698401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 19428 N Maricopa Rd
Maricopa, AZ 85139-2850 - Phone
- (623) 273-6310
- NPI assigned
- Apr 13, 2026
- Last updated
- Apr 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | NU | Primary |
Addresses
Primary practice location
19428 N Maricopa Rd
Maricopa, AZ 85139-2850
Mailing address
4138 E Erie St
Gilbert, AZ 85295-1019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1497698401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4138 E ERIE ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852951019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19428 N MARICOPA RD",
"city": "MARICOPA",
"state": "AZ",
"postal_code": "851392850",
"telephone_number": "623-273-6310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-13",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maricopa, AZ
- Eclipse Psychiatry, PLC
- Eden Behavioral Health LLC
- Lisa Helen Edwards, B.A., SLPA
- Elinat Health Care LLC (Behavioral Group Home)
- Darrell Lemont Ellis Jr., ADMINISTRATOR
- Emani Care Homes LLC
- Emmadeline Home Care LLC
- Empact - Suicide Prevention Center (La Frontera EMPACT-SPC)
- Empact - Suicide Prevention Center
- Empact - Suicide Prevention Center (Empact-SPC)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.