Individual provider Active NPI

Charvette Gaitone Shumaker-Kirk, AGACNP-; AGPCNP

  • Gerontology Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1003280975
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP193221 Issued in GA
Practice address
36 Linden Ave NE
Atlanta, GA 30308-2951
Phone
(404) 778-1900
NPI assigned
Nov 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP193221 GA Primary
Acute Care Nurse Practitioner 363LA2100X RN193221 GA
Adult Health Nurse Practitioner 363LA2200X RN193221 GA
Nurse Practitioner 363L00000X RN193221 GA
Hematology & Oncology Physician 207RH0003X RN193221 GA

Addresses

Primary practice location

36 Linden Ave NE
Atlanta, GA 30308-2951

Mailing address

7891 Gable Dr
Douglasville, GA 30135-6403

Other identifiers 1

IdentifierTypeStateIssuer
003173092BMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151124000106 GA Practitioner - Nurse Practitioner 6002116001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

  • Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN193221GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Hematology & Oncology CurrentSince Jul 23, 2023 Accepting new patients
Cogent Healthcare of Georgia PC Nurse Practitioner CurrentSince Jan 1, 2021 Accepting new patients
Northside Imaging LLC Past Accepting new patients
NSH Cancer Institute Professional Services G, LLC Hematology & Oncology Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1003280975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7891 GABLE DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 LINDEN AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082951",
            "telephone_number": "404-778-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKER-KIRK",
        "first_name": "CHARVETTE",
        "middle_name": "GAITONE",
        "name_prefix": "Ms.",
        "credential": "AGACNP-; AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "NP193221",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN193221",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN193221",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN193221",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "GA",
            "license": "RN193221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003173092B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.