Active NPI
Shindella Denise Willis, CNCS,CBE,CD,CBC,CPD
- Doula
- Richmond Hill, GA
National Provider Identifier
1114709185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 4457
- Practice address
- 467 Belle Grove Cir
Richmond Hill, GA 31324-3724 - Phone
- (912) 217-7561
- NPI assigned
- Oct 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | GA | ||
| Lactation Consultant (Non-RN) | 174N00000X | 3941 | GA | |
| Doula | 374J00000X | 4457 | GA | Primary |
Addresses
Primary practice location
467 Belle Grove Cir
Richmond Hill, GA 31324-3724
Mailing address
467 Belle Grove Cir
Richmond Hill, GA 31324-3724
Phone (912) 217-7561
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3941 | GA | MD | Lactation Consultant (Non-RN) |
| 4457 | GA | MD | Doula |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697414400000",
"number": "1114709185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "467 BELLE GROVE CIR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313243724",
"telephone_number": "912-217-7561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 BELLE GROVE CIR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313243724",
"telephone_number": "912-217-7561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "SHINDELLA",
"middle_name": "DENISE",
"credential": "CNCS,CBE,CD,CBC,CPD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-16",
"last_updated": "2023-10-16",
"certification_date": "2023-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "GA",
"license": "3941",
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "GA",
"license": "4457",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.