Individual provider Active NPI

Shannon Reynolds, NP

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1194133348
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN173458 Issued in GA
Practice address
890 2ND St
Suite 201
Macon, GA 31201-6863
Phone
(478) 745-4322
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN173458 GA Primary

Addresses

Primary practice location

890 2ND St
Suite 201
Macon, GA 31201-6863

Mailing address

890 2ND St Ste 201
Macon, GA 31201-6863
Phone (478) 745-4322

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141020000669 GA Practitioner - Nurse Practitioner 6103047063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Georgia Kidney Specialists, PCGroup PAC ID 7810885506, 8 clinicians

Practice addresses (Care Compare)

1520 N Columbia St
Suite 101
Milledgeville, GA 31061-2475
Phone (478) 745-4322

745 Pine St
Macon, GA 31201-2106
Phone (478) 745-4322

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 745-4322

821 N Cobb St
Milledgeville, GA 31061-2343
Phone (478) 745-4322

890 2ND St
Suite 201
Macon, GA 31201-6863
Phone (478) 745-4322

Hospital & facility affiliations

  • Navicent Health Baldwin Hospital, Milledgeville, GA, CCN 110150
  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN173458GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georgia Kidney Specialists, PC CurrentSince Feb 1, 2017 Accepting new patients

Locations

890 2nd St
Ste 201
Macon, GA 31201
Phone (478) 745-7322

747 2nd St
Macon, GA 31201
Phone (478) 742-4211

745 Pine St
Macon, GA 31201
Phone (478) 476-0196

657 Hemlock St
Ste 200
Macon, GA 31201
Phone (478) 254-7353

821 N Cobb St
Milledgeville, GA 31061
Phone (478) 454-3500

1520 N Columbia St
Ste 101
Milledgeville, GA 31061

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIFEAA

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1194133348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 2ND ST STE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 2ND ST",
            "address_2": "SUITE 201",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016863",
            "telephone_number": "478-745-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHANNON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN173458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.