Individual provider Active NPI

Shauna Michaels, LCSW

  • Clinical Social Worker
  • Chico, CA
National Provider Identifier
1033535190
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
15 Ilahee LN Ste 100
Chico, CA 95973-7205
Phone
(530) 514-9408
NPI assigned
Mar 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

15 Ilahee LN Ste 100
Chico, CA 95973-7205

Mailing address

2860 Native Oak Dr
Chico, CA 95928-7198
Phone (530) 513-9408

Other practice location 1

15 Declaration Dr
Chico, CA 95973-4902
Phone (530) 893-4784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213002865 GA Practitioner - Clinical Social Worker 8921534918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Aug 3, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Aug 3, 2024 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1033535190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 NATIVE OAK DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287198",
            "telephone_number": "530-513-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ILAHEE LN STE 100",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737205",
            "telephone_number": "530-514-9408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Declaration Dr",
            "address_purpose": "LOCATION",
            "city": "Chico",
            "state": "CA",
            "postal_code": "959734902",
            "country_code": "US",
            "telephone_number": "530-893-4784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "SHAUNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.