Shirlene D Royal, RN,FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN077506 Issued in GA

Practice address

1309 Ocilla Rd Ste a
Douglas, GA 31533-2209

Phone

(912) 384-2252

Fax

(912) 384-8888

NPI assigned

Apr 12, 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

Other identifiers 1

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, Registered Nurse

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.

• South Central Primary Care Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ocilla, GA
  • NPI 1891978854
  Medicare reassignment

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1154545077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317740749",
            "telephone_number": "229-468-9166",
            "fax_number": "229-468-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 OCILLA RD STE A",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332209",
            "telephone_number": "912-384-2252",
            "fax_number": "912-384-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYAL",
        "first_name": "SHIRLENE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "RN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN077506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000734038H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carey Leigh Roberts, NP-C
• Allison Tucker Rodriguez, NP-C
• Jodi Rogers
• Luis David Rojas, D.C.
• Roy Powells Drug Store Inc
• Chester Theo Royals Jr., M.D.
• Veronica Russ
• Mohammad Salman, MD
• Akkaraju V.S. Sarma, M.D.,
• Satilla Regional Cancer Treatment Center

• Family Nurse Practitioner in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.