Mrs Shonta Ellison, APRN is a medicare enrolled "Clinical Nurse Specialist - Adult Health" in Maumelle, Arkansas. Her current practice location is
130 Lake Valley Dr, Maumelle, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(501) 766-1884.
Mrs Shonta Ellison is licensed to practice in Arkansas (license number S002325) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487138608.
Provider's Profile
Full Name | Mrs Shonta Ellison |
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Gender | Female |
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Speciality | Clinical Nurse Specialist - Adult Health |
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Location | 130 Lake Valley Dr, Maumelle, Arkansas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487138608
- Provider Enumeration Date: 09/24/2018
- Last Update Date: 09/24/2018
Medicare PECOS Information:
- PECOS PAC ID: 7214334481
- Enrollment ID: I20210930002438
Medical Identifiers
Medical identifiers for Mrs Shonta Ellison such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487138608 | NPI | - | NPPES |
S002325 | Other | AR | CNS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
364SG0600X | Clinical Nurse Specialist - Gerontology | S002325 (Arkansas) | Secondary |
364SA2200X | Clinical Nurse Specialist - Adult Health | S002325 (Arkansas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shonta Ellison allows following entities to bill medicare on her behalf.
Entity Name | Arkansas Pain Centers, Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1811984099 PECOS PAC ID: 7012987845 Enrollment ID: O20040729000319 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shonta Ellison is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Shonta Ellison, APRN 130 Lake Valley Dr, Maumelle, AR 72113-5939 Ph: (501) 766-1884 | Mrs Shonta Ellison, APRN 130 Lake Valley Dr, Maumelle, AR 72113-5939 Ph: (501) 766-1884 |
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