Individual provider Active NPI

Shermaine Gayle

  • Home Modifications Contractor
  • Atlanta, GA
National Provider Identifier
1104761741
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
GCCO007687 Issued in GA
Practice address
793 Miller Run
Atlanta, GA 30349-7916
Phone
(404) 610-0969
NPI assigned
Apr 21, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X GCCO007687 GA Primary

Addresses

Primary practice location

793 Miller Run
Atlanta, GA 30349-7916

Mailing address

793 Miller Run
Atlanta, GA 30349-7916

Other names 1

  • Shermaine Nettles Former name

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
GCCO007687GAMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1776729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1104761741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 MILLER RUN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303497916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 MILLER RUN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303497916",
            "telephone_number": "404-610-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLE",
        "first_name": "SHERMAINE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-04-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "GA",
            "license": "GCCO007687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERMAINE",
            "last_name": "NETTLES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 21, 2026; 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.