Individual provider Active NPI

Shalandra Ross, MD

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
National Provider Identifier
1215109137
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
64457 Issued in GA
Practice address
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone
(404) 756-1400
Fax
(404) 756-1402
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 64457 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Mailing address

720 Westview Dr SW Ste 100
Atlanta, GA 30310-1458
Phone (404) 756-1400

Other identifiers 3

IdentifierTypeStateIssuer
844893646GMedicaidGA
844893646IMedicaidGA
844893646HMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110211000634 GA Practitioner - Obstetrics/Gynecology 5092995738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Southern Illinois University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse Healthcare, Inc.Group PAC ID 6002701273, 155 clinicians

Practice addresses (Care Compare)

1595 W Cleveland Ave
East Point, GA 30344-3200
Phone (404) 305-8086

Hospital & facility affiliations

  • Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
64457GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Medical Center, Inc. Current Accepting new patients
Morehouse Healthcare, Inc. Obstetrics & Gynecology CurrentSince Jan 15, 2011 Accepting new patients
Medcura Health, Inc. CurrentSince Aug 9, 2015 Accepting new patients
Medcura Health, Inc. CurrentSince Aug 9, 2015 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

75 Piedmont Ave NE
Ste 700
Atlanta, GA 30303
Phone (404) 756-1410

720 Westview Dr SW
Ste 100
Atlanta, GA 30310
Phone (404) 756-5752

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

5582 Memorial Dr
Stone Mountain, GA 30083
Phone (404) 513-9965

770 Village Square Dr
Stone Mtn, GA 30083
Phone (404) 298-7658

Interoperability endpoints

  • Direct secure messaging: shalandra.ross1@gadirect.net

Organizations & group practices 5

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 1

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1215109137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458",
            "telephone_number": "404-756-1400",
            "fax_number": "404-756-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-756-1400",
            "fax_number": "404-756-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHALANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "64457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844893646G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844893646I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844893646H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.