Kimberly W Shelnutt, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002036 Issued in GA

Practice address

1755 Highway 34 E Ste 1300
Newnan, GA 30265-3186

Phone

(770) 254-7850

NPI assigned

Mar 21, 2007

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

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Medical College of Georgia School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  GA, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Sundance Rehabilitation Agency, LLC

  • Rehabilitation Clinic/Center
  • Athens, GA
  • NPI 1508281411
  NPD (past)
• Sundance Rehabilitation Agency, LLC

  • Rehabilitation Clinic/Center
  • Johns Creek, GA
  • NPI 1760437743
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144346446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 HIGHWAY 34 E PMB 140",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652122",
            "telephone_number": "770-251-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E STE 1300",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302653186",
            "telephone_number": "770-254-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELNUTT",
        "first_name": "KIMBERLY",
        "middle_name": "W",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Allen Shaw Jr., MD
• Kevin James Sheahan, MD
• Kelly Anna Christina Sheldon
• Scott W Shelfo, M.D.
• Jeanette Shelley, RD, LD
• Kyndal R Shelnutt, RBT
• Tatum Shepard, D.C.
• Deborah L Sheppard
• Sharon Diane Shields, D.C.
• Jeffrey David Shirley, CNS

• Occupational Therapist in Newnan, GA
• Providers in Newnan, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.