Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bonnie P Ellenoff, DO

Individual provider Family Medicine Physician · NPI 1306907001

Bonnie P Ellenoff, DO is a Family Practice in Austell, Georgia. Qualified in 1999, 27 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
27
Licensed in
GA
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3640 Tramore Pointe Pkwy Kaiser Permanente West Cobb Medical Ctr
Austell, GA 30106-6825
Phone: (770) 439-4700
Fax: (404) 370-0428
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 051644 (GA)

Record details

NPI number1306907001
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedDecember 13, 2006
Last updated in NPPESJanuary 13, 2022
Mailing address3495 Piedmont Rd Ne, Nine Piedmont Center, Atlanta, GA 30305-1717

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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