Individual provider Active NPI

Shaen Deimling, MD

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1134869506
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
104446 Issued in GA
Practice address
3620 Howell Ferry Rd
Duluth, GA 30096-3178
Phone
(678) 312-6800
NPI assigned
Mar 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 104446 GA Primary

Addresses

Primary practice location

3620 Howell Ferry Rd
Duluth, GA 30096-3178

Mailing address

3620 Howell Ferry Rd
Duluth, GA 30096-3178

Other practice location 1

450 Northside Cherokee Blvd
Canton, GA 30115-8015
Phone (770) 224-1000

Other practice location 2

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

Other practice location 3

1000 Johnson Fy Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

Other practice location 4

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250825001225 GA Practitioner - Internal Medicine 7810379989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (770) 255-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104446GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

3620 Howell Ferry Rd
Duluth, GA 30096
Phone (678) 312-3294

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1134869506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 HOWELL FERRY RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 HOWELL FERRY RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963178",
            "telephone_number": "678-312-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Northside Cherokee Blvd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158015",
            "country_code": "US",
            "telephone_number": "770-224-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Johnson Fy Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421606",
            "country_code": "US",
            "telephone_number": "404-851-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Northside Forsyth Dr",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417659",
            "country_code": "US",
            "telephone_number": "770-844-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEIMLING",
        "first_name": "SHAEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "104446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.