Shontreka Akisha Glover, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN 155519 Issued in GA

Practice address

150 N Park TRL Ste B
Stockbridge, GA 30281-7372

Phone

(770) 507-0909

Fax

(770) 507-1919

NPI assigned

Jan 13, 2014

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381

  Nurse Practitioner

  Medicare reassignment NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD
• Community Care Health Network LLC

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  GA

  Medicare reassignment NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  GA

  Medicare reassignment NPD
• Physiatry Consultants of Ga LLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1609468248

  GA

  Medicare reassignment NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1659537165
  NPD

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1134541097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SUMMIT BLVD STE 200",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303196410",
            "telephone_number": "770-989-1668",
            "fax_number": "678-388-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N PARK TRL STE B",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817372",
            "telephone_number": "770-507-0909",
            "fax_number": "770-507-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "SHONTREKA",
        "middle_name": "AKISHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-13",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN 155519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin A Glenn, MMSC, PA
• Global Research Holdings LLC
• Global Therapy Services, LLC
• Glory Health Care and in Home Services
• Ivan Glotov, PA
• Tiffany Glover, LPC
• Megan Goeken, OTRL
• Gofs Stockbridge
• Nancy Gogins, LPC
• Deannaca Latese Golatte, APRN

• Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.