DR. SHANNON SCOTT ELLIS (MD) – Family Medicine Physician, NPI 1124219563
Family Medicine Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,103 FAMILY PRACTICE in GA
Provider Addresses for DR. SHANNON SCOTT ELLIS (MD)
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
ATLANTA, GA 303742616
Phone: (770) 219-8420
Type: Mailing
26 W JACKSON COMMONS DR
HOSCHTON, GA 305481897
Phone: (706) 658-2452
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 39 Open Payments records for all available years, with a total value of $800.
Total Amount is formed as General ($800) + Research ($0) + Ownership ($0) = $800.
Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Novo Nordisk Inc ($194).
Total Amount
$800
General + Research + Ownership
Payments
39
Total payment records
General Amount
$800
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $194 |
| PFIZER INC. | $111 |
| Lilly USA, LLC | $104 |
| Theratechnologies Inc. | $100 |
| Abbott Laboratories | $62 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-09-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140911002200 | I | Family Practice | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 543 | 234 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 364 | 210 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 182 | 182 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 132 | 99 | $0 |
| 83036 | Hemoglobin a1c level | 118 | 85 | $0 |
Insurance plans in this area (ZIP 30374)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | GA | |
| - | GA | |
| - | GA | |
| A N E S T H E S I O L O G Y | GA | |
| - | GA | |
| - | GA | |
| Physician Assistant | GA | |
| Nurse Practitioner | GA | |
| Surgical Oncology, General Surgery | NJ | |
| Pulmonary Disease | NY |
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