Individual provider Active NPI

Jessica Shelnutt, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1083091276
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone
(404) 605-5000
NPI assigned
Apr 27, 2015
Last updated
Apr 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1968 Peachtree Rd NW
Atlanta, GA 30309-1281

Mailing address

701 Mountainbrooke Cir
Stone Mountain, GA 30087-2810
Phone (770) 561-8564

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150730014149 GA Practitioner - Physician Assistant 9032423371 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-5995

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 605-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1083091276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MOUNTAINBROOKE CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872810",
            "telephone_number": "770-561-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE RD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091281",
            "telephone_number": "404-605-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELNUTT",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.