Shena L Ellis-Wilson, QMHS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

13422 Kinsman Rd
Cleveland, OH 44120-4410

Phone

(216) 283-4400

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1801393111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 BANCROFT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441056664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 KINSMAN RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441204410",
            "telephone_number": "216-283-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS-WILSON",
        "first_name": "SHENA",
        "middle_name": "L",
        "credential": "QMHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lottie Elliott, LSW
• Makaylah Elliott
• Natalie Elliott, MD
• Terri Elliott
• Leah Ellis-Jones, RN
• Andre Ellis
• Arthur Ellis, QMHS
• Courtney Nicole Ellis
• Jeana Ellis
• Kathryn L Ellis

• Case Manager/Care Coordinator in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.