Shazzanne Kahelia Pennant, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

100160 Issued in GA

Practice address

1101 Nortec Dr SE
Conyers, GA 30013-5835

Phone

(678) 374-7514

NPI assigned

Apr 21, 2021

Last updated

Jun 11, 2024By 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 2

Addresses

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

Specialty

Family Practice

Education

Howard University College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Visiting Nurse Health System, Inc Home health agency, Marietta, GA, CCN 117000
• Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
• Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  Medicare reassignment Care Compare group NPD
• Aylo Health, LLC

  • Diagnostic Radiology Physician
  • Locust Grove, GA
  • NPI 1194433219
  NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

• Piedmont Newton Hospital, Inc.

  dba Newton Medical Center

  • General Acute Care Hospital
  • Covington, GA
  • NPI 1760498588
  Care Compare affiliation
• Piedmont Rockdale Hospital Inc.

  • General Acute Care Hospital
  • Conyers, GA
  • NPI 1306355680
  Care Compare affiliation
• Visiting Nurse Health System, Inc

  • Home Health Agency
  • Marietta, GA
  • NPI 1992766273
  Care Compare affiliation

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1235711185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NORTEC DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300135835",
            "telephone_number": "678-374-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNANT",
        "first_name": "SHAZZANNE",
        "middle_name": "KAHELIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "100160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Center for Wellness
• Pediatric Health Care of Conyers
• Avis W Peek, D.C.
• Pelagie Care Clinic
• Pelagie Foundation LTD (Pelagie Resource Center)
• Larry Pennington, RPH
• Gustavo Andre Perez Caballero, BS, DC, GTS
• Performance Chiropractic of Georgia
• Peridot and Emerald Mobile Services, LLC
• Periodontal Center of Georgia, PC (Periodontal Center of Georgia)

• Family Medicine Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.