Individual provider Active NPI

Ann Patricia Shannon, LCSW

  • Clinical Social Worker
  • Cleveland, GA
National Provider Identifier
1134240757
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW003738 Issued in GA
Practice address
2578 Helen Hwy
Cleveland, GA 30528-2848
Phone
(770) 219-9100
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW003738 GA Primary

Addresses

Primary practice location

2578 Helen Hwy
Cleveland, GA 30528-2848

Mailing address

363 Resource Pkwy
Winder, GA 30680-8364
Phone (770) 597-1647

Other practice location 1

363 Resource Pkwy
Winder, GA 30680-8364
Phone (770) 597-1647

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashannon112770@nghs.gadirect.net Direct Northeast Georgia Physicians Group, Inc.

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210311002281 GA Practitioner - Clinical Social Worker 4587070800 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

2578 Helen Hwy
Cleveland, GA 30528
Phone (706) 865-1234

4919 Atlanta Hwy
Flowery Branch, GA 30542
Phone (770) 848-9160

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1134240757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 RESOURCE PKWY",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306808364",
            "telephone_number": "770-597-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2578 HELEN HWY",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305282848",
            "telephone_number": "770-219-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Resource Pkwy",
            "address_purpose": "LOCATION",
            "city": "Winder",
            "state": "GA",
            "postal_code": "306808364",
            "country_code": "US",
            "telephone_number": "770-597-1647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "ANN",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashannon112770@nghs.gadirect.net",
            "affiliation": "Y",
            "affiliationName": "Northeast Georgia Physicians Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2578 Helen Hwy",
            "city": "Cleveland",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305282848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, GA

Sources for this page

Verify at the official NPI Registry.