Individual provider Active NPI

Sheena Rene Gonzalez, CPNP-PC

  • Pediatric Nurse Practitioner
  • Carrollton, GA
National Provider Identifier
1154745545
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN-NP246497 Issued in GA
Practice address
706 Dixie St Ste 220
Carrollton, GA 30117-3889
Phone
(770) 812-8825
Fax
(770) 812-5910
NPI assigned
Feb 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN-NP246497 GA Primary

Addresses

Primary practice location

706 Dixie St Ste 220
Carrollton, GA 30117-3889

Mailing address

706 Dixie St Ste 220
Carrollton, GA 30117-3889
Phone (770) 812-8825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230203002534 ME Practitioner - Nurse Practitioner 6103218466 Reassigns benefits to 1 organization
I20231113002424 GA Practitioner - Nurse Practitioner 6103218466 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP246497GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Jun 10, 2024 Accepting new patients
TMC Immediate Care, Inc CurrentSince Jun 10, 2024 Accepting new patients
Medcura Health, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Nov 11, 2022 Accepting new patients
Central Maine Medical Center Current Accepting new patients
Central Maine Medical Center CurrentSince Nov 11, 2022 Accepting new patients
Medcura Health, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Medcura Health, Inc. Past Accepting new patients
TMC Children'S Healthcare of West Georgia PastSince Jun 10, 2024 Accepting new patients

Locations

1480 S Highway 27
Carrollton, GA 30117
Phone (770) 812-9445

100 Greenway Blvd
Fl 2
Carrollton, GA 30117
Phone (770) 838-8710

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

706 Dixie St
Ste 210
Carrollton, GA 30117
Phone (770) 812-8640

1706 Candler Rd
Decatur, GA 30032

2162 Second Ave
Decatur, GA 30032

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

101 Quartz Dr
Ste 101
Villa Rica, GA 30180
Phone (770) 836-9445

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

12 High St
Ste 301
Lewiston, ME 04240
Phone (207) 795-5730

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 9

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": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1154745545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 220",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173889",
            "telephone_number": "770-812-8825",
            "fax_number": "770-812-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 220",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173889",
            "telephone_number": "770-812-8825",
            "fax_number": "770-812-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "SHEENA",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP246497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.