Mrs Shonta Ellison, APRN - Medicare Clinical Nurse Specialist in Maumelle, AR

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.

Contact Information

Mrs Shonta Ellison, APRN
130 Lake Valley Dr,
Maumelle, AR 72113-5939
(501) 766-1884
Not Available



Provider's Profile

Full NameMrs Shonta Ellison
GenderFemale
SpecialityClinical Nurse Specialist - Adult Health
Location130 Lake Valley Dr, Maumelle, Arkansas
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1487138608NPI-NPPES
S002325OtherARCNS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
364SG0600XClinical Nurse Specialist - Gerontology S002325 (Arkansas)Secondary
364SA2200XClinical 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 NameArkansas Pain Centers, Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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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Clinical Nurse Specialist Nurses in Maumelle, AR


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