Individual provider Active NPI

Jeremy Marquez Shinholster

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1013679968
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP258849 Issued in GA
Practice address
124 3Rd St
Macon, GA 31201-3404
Phone
(478) 751-2900
NPI assigned
Oct 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP258849 GA Primary

Addresses

Primary practice location

124 3Rd St
Macon, GA 31201-3404

Mailing address

124 3Rd St
Macon, GA 31201-3404
Phone (478) 751-2900

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
I20240229000663 GA Practitioner - Nurse Practitioner 1052756004 Reassigns benefits to 1 organization

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
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

1006 Hillcrest Pkwy
Suite 1
Dublin, GA 31021-4259
Phone (578) 354-4240

1363 Sam Nunn Blvd
Suite 200
Perry, GA 31069-2121
Phone (470) 750-2905

1909 N Columbia St
Milledgeville, GA 31061-2170
Phone (478) 354-4250

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

5585 Thomaston Rd
A600
Macon, GA 31220-8200
Phone (478) 354-4200

5791 Zebulon Rd
Suite a
Macon, GA 31210-2025
Phone (478) 845-4640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP258849GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Jan 17, 2024 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1013679968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 3RD ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013404",
            "telephone_number": "478-751-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 3RD ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013404",
            "telephone_number": "478-751-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINHOLSTER",
        "first_name": "JEREMY",
        "middle_name": "MARQUEZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-07",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP258849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.