Sharlene Maynor, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN163859 Issued in GA

Practice address

81 Upper Riverdale Rd SW
Ste 210
Riverdale, GA 30274-2634

Phone

(770) 996-1200

Fax

(770) 907-2334

NPI assigned

Apr 10, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smaynor21794@direct.emory.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment Care Compare group NPD
• My OBGYN PC

  • Specialist
  • Riverdale, GA
  • NPI 1669534210
  NPD (past)
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1003202599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962380",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966921",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 UPPER RIVERDALE RD SW",
            "address_2": "STE 210",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742634",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNOR",
        "first_name": "SHARLENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN163859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Michael Martin, MD
• Jacquelyn Hairston Martin, C-FNP
• Kandathil M. Mathew, M.D.
• Lauren Ashley Mattox, PMHNP
• Maxicare Medical Supply
• Efiong E. Mbaba, REGISTERED NURSE
• Dominique Mary McCray
• Terry L McCulloch, DDS
• Nikitress McGill
• Monica McIntyre, DDS

• Women's Health Nurse Practitioner in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.