Shelby Giles
Individual provider Active NPI Gerontology Nurse Practitioner · Bonaire, GA
NPI 1194491506 · NPPES record last updated Jun 19, 2025
Key facts
- NPI
- 1194491506
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- RN258729 (GA)
- Practice address
- 127 Old Highway 96 Ste B
Bonaire, GA 31005-3461 - Phone
- (478) 352-7143
- NPI assigned
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20221108001285 | GA | Practitioner - Nurse Practitioner | 4486021268 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Medical Group, P.C. | Current |
Accepting new patients |
Locations
127 Old Highway 96
Ste B
Bonaire, GA 31005
Phone (478) 352-7143
1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350
4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406
305 Osigian Blvd
Warner Robins, GA 31088
Phone 47837444305
1282 S Houston Lake Rd
Warner Robins, GA 31088
Phone (478) 313-3509
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DIJIBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | RN258729 | GA | Yes |
Addresses
Primary practice location
127 Old Highway 96 Ste B
Bonaire, GA 31005-3461
Mailing address
4300 N Point Pkwy Ste 300
Alpharetta, GA 30022-4102
Other practice location 1
305 Osigian Blvd
Warner Robins, GA 31088-8953
Phone (478) 953-9999
Other providers in Bonaire, GA
- Laura Lenhard Frawley
- Kelsey Galeano
- Rogea Vincetta Gaymon
- Georgia Chiropractic and Wellness LLC
- Georgia Dental Professionals, PC
- Melissa Lauren Godbee
- Christy Ann Gonzalez
- Kimberly Michelle Grace
- Graceful Care Case Management
- Carroanita Hall
All providers in Bonaire, GA · Gerontology 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 Jun 19, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.