Sherenda Lashawn Ellis

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

9Y6C9J8J7 Issued in GA

Practice address

1058 Wedgewood CT
Conyers, GA 30012-7120

Phone

(404) 453-7777

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1821603606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 HUGH HOWELL RD STE 1179",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844721",
            "telephone_number": "404-453-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 WEDGEWOOD CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300127120",
            "telephone_number": "404-453-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SHERENDA",
        "middle_name": "LASHAWN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "GA",
            "license": "9Y6C9J8J7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernard Peter Elkon, LPC
• Elks Aidmore, Inc.
• Ellen Paige Montgomery, LLC
• Caroline Ellis
• Selina Y Ellis
• Howard Steven Ellison, MD
• Margaret Gibson Ellison, EDS, LPC, MAC, CAS
• Avery Louise Elloway, PA-C
• Michelle Emerson
• Roselande Emmanuel, NP

• Phlebotomy Technician in Conyers, GA
• Providers in Conyers, GA by specialty
• Phlebotomy Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.