Charlotte B. Shaak, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

040997 Issued in GA

Practice address

5901 Peachtree Dunwoody Rd NE
Suite B 420
Atlanta, GA 30328-5382

Phone

(404) 252-9751

Fax

(678) 990-5763

NPI assigned

Jul 12, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Neonatology Associates of Atlanta, P.C.

  • Neonatal-Perinatal Medicine Physician
  • Atlanta, GA
  • NPI 1194822809
  NPD (past)
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1104824291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE B 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285382",
            "telephone_number": "404-252-9751",
            "fax_number": "678-990-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE B 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285382",
            "telephone_number": "404-252-9751",
            "fax_number": "678-990-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAAK",
        "first_name": "CHARLOTTE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "040997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474215132C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474215132F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474215132A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sfaba Ga LLC
• SG Mental Health Care LLC
• Sga Care of Ga II, LLC
• Sga Care of Ga, LLC
• Elaine E Sha, PT, CSCS
• George W. Shaak, M.D.
• Mustaphasahim H Shaaraoui, MD
• Osaze Shabazz
• Yamini Shabazz
• Jocelyn Shackelford, MA, LAT, ATC

• All providers in Atlanta, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.

Verify at the official NPI Registry.