Shelleyann Beaubrun, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN193787 Issued in GA

Practice address

4136 Newton Dr NE
Covington, GA 30014-2521

Phone

(770) 569-3205

NPI assigned

Nov 5, 2014

Last updated

Apr 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chris 180, Inc.

  • Community/Behavioral Health Agency
  • Atlanta, GA
  • NPI 1134257827
  Medicare reassignment NPD
• Integrative Psychiatry Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Covington, GA
  • NPI 1508617176
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1083010961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 SILVERTON DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302524222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 NEWTON DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142521",
            "telephone_number": "770-569-3205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1017 Fayetteville Rd SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303162932",
            "country_code": "US",
            "telephone_number": "404-324-4191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUBRUN",
        "first_name": "SHELLEYANN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN193787",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN193787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niesha Barnett
• Lulatha Bartley
• Nicholas M Bath, M.D.
• Steven Peter Bauernfeind, PT, DPT
• Beacon Point Counseling & Wellness LLC
• Fuquan Carl Beeks
• Bef Insurance Solutions LLC
• Keith Everett Bell
• Quindarius Bell
• Beloved Care Corporation (Visiting Angels)

• Psychiatric/Mental Health Nurse Practitioner in Covington, GA
• Providers in Covington, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.