Shawana Mitchell Taylor, FNP
Individual provider Active NPI Family Nurse Practitioner · Waycross, GA
NPI 1164043055 · NPPES record last updated May 1, 2020
Key facts
- NPI
- 1164043055
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN239880 (GA)
- Practice address
- 1115 Porter St
Waycross, GA 31501-5640 - Phone
- (912) 550-5458
- NPI assigned
- May 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Unison Behavioral Health
Practice addresses (Care Compare)
1007 Mary St
Waycross, GA 31503-3823
Phone (912) 285-6142
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220502000960 | GA | Practitioner - Nurse Practitioner | 7416344973 | Reassigns benefits to 2 organizations |
| I20230525002924 | FL | Practitioner - Nurse Practitioner | 7416344973 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unison Behavioral Health | Current |
Accepting new patients | |
| Unison Behavioral Health | Current |
Accepting new patients |
Locations
1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN239880 | GA | Yes |
Addresses
Primary practice location
1115 Porter St
Waycross, GA 31501-5640
Mailing address
1115 Porter St
Waycross, GA 31501-5640
Phone (912) 550-5458
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | taylor.shawanajuan@outlook.com |
Other providers in Waycross, GA
- Lindsey Rene Tatum
- Ricky O Tatum
- Alice R Taylor
- Crystal L Taylor
- Leslie C. Taylor
- Tech Medical Center, LLC
- Mekedese Tesfaye
- The Clark Eye Clinic, PC
- The Friendship Hub
- The Kroger Co
All providers in Waycross, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.