Individual provider Active NPI

Taylor Ponder Shiver, FNP-C

  • Family Nurse Practitioner
  • Pelham, GA
National Provider Identifier
1215670385
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN255327 Issued in GA
Practice address
919 Gilliard Rd
Pelham, GA 31779-4215
Phone
(229) 327-7349
NPI assigned
Apr 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 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 RN255327 GA Primary

Addresses

Primary practice location

919 Gilliard Rd
Pelham, GA 31779-4215

Mailing address

919 Gilliard Rd
Pelham, GA 31779-4215
Phone (229) 327-7349

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
I20250623000251 GA Practitioner - Nurse Practitioner 1557873023 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians
Amgir, Inc.Group PAC ID 6406127612, 4 clinicians

Practice addresses (Care Compare)

100 Mimosa Dr
Thomasville, GA 31792-6676
Phone (229) 228-5500

900 Gordon Ave
Thomasville, GA 31792-6613
Phone (229) 226-0125

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

  • Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN255327GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Sep 26, 2025 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Sep 26, 2025 Accepting new patients
Amgir, Inc. CurrentSince Jun 1, 2025 Accepting new patients

Locations

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

900 Gordon Ave
Thomasville, GA 31792
Phone (229) 226-0125

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

Organizations & group practices 3

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": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1215670385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 GILLIARD RD",
            "city": "PELHAM",
            "state": "GA",
            "postal_code": "317794215",
            "telephone_number": "229-327-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 GILLIARD RD",
            "city": "PELHAM",
            "state": "GA",
            "postal_code": "317794215",
            "telephone_number": "229-327-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVER",
        "first_name": "TAYLOR",
        "middle_name": "PONDER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN255327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, GA

Sources for this page

Verify at the official NPI Registry.