Shannon Nicole Myers, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

070628 Issued in GA

Practice address

3727 Executive Center Dr
Augusta, GA 30907-2398

Phone

(706) 842-5331

Fax

(706) 842-5351

NPI assigned

Jun 22, 2010

Last updated

Jun 11, 2019By the provider in NPPES

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Able Pediatrics Health Services LLC

  • Pediatric Occupational Therapist
  • Augusta, GA
  • NPI 1194235028
  Authorized official Same address or phone
• Able Pediatrics LLC

  • Pediatrics Physician
  • Augusta, GA
  • NPI 1669913208
  Authorized official Same address or phone

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1184945339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 EXECUTIVE CENTER DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072398",
            "telephone_number": "706-842-5331",
            "fax_number": "706-842-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 EXECUTIVE CENTER DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072398",
            "telephone_number": "706-842-5331",
            "fax_number": "706-842-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "070628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00139195G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Michelle Myers, RBT
• Christopher Lederle Myers, PA-C
• Hannah Myers, MD
• Herbert Roger Myers, CRNA
• Michael L Myers, DMD
• Trisha Myers, NP
• William J Myers, MD
• Myeyedr Optometry of Georgia, LLC (MyEyeDr)
• Myeyedr Optometry of Georgia, LLC (MyEyeDr)
• N. Elaine Godbee, DMD, PC

• Pediatrics Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.