Shannon B Ellis, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

29221 Issued in AL

Practice address

800 Saint Vincents Dr
Suite 500, North Tower
Birmingham, AL 35205-1620

Phone

(205) 933-8334

Fax

(205) 933-8466

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Shannon Alise Bryant Former name

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Alabama School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Birmingham Obstetrics Gynecology, PCGroup PAC ID 9638068695, 15 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.400334

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.

• Birmingham Obstetrics Gynecology, P.C.

  • Obstetrics & Gynecology Physician
  • Birmingham, AL
  • NPI 1740390640
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1740483734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SAINT VINCENTS DR",
            "address_2": "SUITE 500, NORTH TOWER",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051620",
            "telephone_number": "205-933-8334",
            "fax_number": "205-933-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SAINT VINCENTS DR",
            "address_2": "SUITE 500, NORTH TOWER",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051620",
            "telephone_number": "205-933-8334",
            "fax_number": "205-933-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SHANNON",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "29221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-15776",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138048",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BRYANT",
            "middle_name": "ALISE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles H. Ellis, DMD
• Frank Ellis, AGACNP
• Jack Ellis, P.T.
• Kelli S Ellis, M.S. CCC-SLP
• Richard Leroy Ellis, MD
• Brandon Taylor Ellison
• Brian Ellison
• Clayton Samuel Ellison, D.C.
• India Ellison
• Jenny Ellison, M.S., CCC-SLP

• Obstetrics & Gynecology Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Obstetrics & Gynecology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.