Individual provider Active NPI

Shannon Baker Hummel, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1043959372
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP139359 Issued in GA
Practice address
5965 Parkway North Blvd Ste C
Cumming, GA 30040-1431
Phone
(770) 886-5700
Fax
(770) 886-0404
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP139359 GA Primary
Registered Nurse 163W00000X RN139359 GA

Addresses

Primary practice location

5965 Parkway North Blvd Ste C
Cumming, GA 30040-1431

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other identifiers 1

IdentifierTypeStateIssuer
RN139359OtherGAAPRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220817003158 GA Practitioner - Nurse Practitioner 2769865146 Reassigns benefits to 1 organization
I20241111001693 OR Practitioner - Nurse Practitioner 2769865146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

850 Mayfield Rd
Suite 203
Milton, GA 30009-3008
Phone (470) 805-5040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN139359GAMDRegistered Nurse
APRN-NP139359GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McArthur Gruff & Associates LLC Psychiatric/Mental Health CurrentSince Sep 5, 2024 Accepting new patients
Personal Recovery Network LLC CurrentSince Sep 20, 2022 Accepting new patients

Locations

1846 E Innovation Park Dr
Oro Valley, AZ 85755
Phone (520) 329-2699

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

7426 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 771-0555

5965 Parkway North Blvd
Ste C
Cumming, GA 30040
Phone (770) 475-8014

850 Mayfield Rd
Ste 203
Milton, GA 30009
Phone (470) 805-5040

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

395 SW Bluff Dr
Ste 10
Bend, OR 97702
Phone (503) 755-6703

535 SE Washington St
Hillsboro, OR 97123
Phone (503) 755-6703

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.shannon.hummel@124220.advancedmd-direct.com

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": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1043959372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 PARKWAY NORTH BLVD STE C",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401431",
            "telephone_number": "770-886-5700",
            "fax_number": "770-886-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "SHANNON",
        "middle_name": "BAKER",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP139359",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN139359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "RN139359",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.