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

Mrs. Mindy Shook Ellis, ATC

Individual provider Athletic Trainer · NPI 1720412265

Mrs. Mindy Shook Ellis, ATC is an Athletic Trainer in Vidalia, Georgia. Licensed in Georgia. Registered with an NPI since 2013.

Licensed in
GA
In the registry since
2013
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

101 Harris Industrial Blvd
Vidalia, GA 30474-8852
Phone: (912) 277-2033
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT001661 (GA)

Record details

NPI number1720412265
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC
Sole proprietorNo
NPI enumeratedAugust 31, 2013
Last updated in NPPESAugust 31, 2013

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