Individual provider Active NPI

Shannon Laquita Scott, CNA

  • Nurse's Aide
  • Gainesville, GA
National Provider Identifier
1073283081
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0012967181 Issued in GA
Practice address
2393 Marbleridge Dr
Gainesville, GA 30501-7823
Phone
(678) 769-8939
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0012967181 GA Primary

Addresses

Primary practice location

2393 Marbleridge Dr
Gainesville, GA 30501-7823

Mailing address

2393 Marbleridge Dr
Gainesville, GA 30501-7823
Phone (678) 769-8939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CN0012967181GAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1073283081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2393 MARBLERIDGE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017823",
            "telephone_number": "678-769-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2393 MARBLERIDGE DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017823",
            "telephone_number": "678-769-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "SHANNON",
        "middle_name": "LAQUITA",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0012967181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.