Shujuan Holdings LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SHUJUAN HOLDINGS LLC

Practice address

110 E Paces Dr
Athens, GA 30605-5217

Phone

(706) 270-1605

NPI assigned

Sep 9, 2020

Organization subpart

Yes

Parent organization

TAGGART ATLANTIC HEALTHCARE LLCAs reported in NPPES

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

Authorized official

Name

Mr. Crawford Kelly McDonald

Title

Manager

Phone

(706) 270-1605

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1154936037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W WALNUT AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203951",
            "telephone_number": "706-270-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E PACES DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306055217",
            "telephone_number": "706-270-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUJUAN HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAGGART ATLANTIC HEALTHCARE LLC",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "CRAWFORD",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "706-270-1605",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shree Kesrinandan LLC
• Shree Kesrinandan LLC
• Shivanee Shrestha, M.D.
• Tedra Dorothy Lucille Shriner, ED.S, LPC
• Sara J Shue, MS, OTR/L
• Michael S Shuler, MD
• Larry Yancey Shuman, PA-C
• Rubina Sial, M.D.
• Omar Ahmed Siddiqui, PHARMD
• Julie Beth Siegel, MD

• Adult Care Home Facility in Athens, GA
• Providers in Athens, GA by specialty
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.