Active NPI
Shadiyah S Tawwab, CRNP
- Family Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1063987162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-136441
- Practice address
- 2140 Peachtree Rd NW Ste 232
Atlanta, GA 30309-1316 - Phone
- (888) 708-0561
- Fax
- (404) 585-2688
- NPI assigned
- Oct 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-136441 | AL | Primary |
Addresses
Primary practice location
2140 Peachtree Rd NW Ste 232
Atlanta, GA 30309-1316
Mailing address
1372 Commerce Dr Apt C2
Auburn, AL 36830-1859
Other practice location 1
1702 Catherine Ct Ste 1A
Auburn, AL 36830-5790
Phone (334) 501-1081
Other practice location 2
3316 Highway 280
Alexander City, AL 35010-3369
Phone (256) 329-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery AIDS Outreach, Inc. | Past | Accepting new patients |
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.
-
- Medical Specialty Clinic/Center
- Montgomery, AL
- NPI 1689651408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1063987162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1372 COMMERCE DR APT C2",
"city": "AUBURN",
"state": "AL",
"postal_code": "368301859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 PEACHTREE RD NW STE 232",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091316",
"telephone_number": "888-708-0561",
"fax_number": "404-585-2688"
}
],
"practiceLocations": [
{
"address_1": "1702 Catherine Ct Ste 1A",
"address_purpose": "LOCATION",
"city": "Auburn",
"state": "AL",
"postal_code": "368305790",
"country_code": "US",
"telephone_number": "334-501-1081",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3316 Highway 280",
"address_purpose": "LOCATION",
"city": "Alexander City",
"state": "AL",
"postal_code": "350103369",
"country_code": "US",
"telephone_number": "256-329-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAWWAB",
"first_name": "SHADIYAH",
"middle_name": "S",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-04",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-136441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.