Shallowford Wellness Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHALLOWFORD WELLNESS CENTER LLC

Practice address

3300 Northeast Expy NE
Atlanta, GA 30341-3932

Phone

(404) 435-6604

NPI assigned

Sep 19, 2023

Organization subpart

No

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

Authorized official

Name

Sofia KhanNPI 1841227592

Title

Ceo

Phone

(404) 435-6604

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Asad Mehdi, M.D.

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1578779898
  Medicare reassignment NPD
• Sofia Aman Khan, M.D

  • Emergency Medicine Physician
  • Decatur, GA
  • NPI 1841227592
  NPD Authorized official
• Kimberly Renae Cromartie, LMSW

  • Mental Health Counselor
  • Atlanta, GA
  • NPI 1285496521
  NPD (past)
• Kierston Hurst

  • Psychiatric/Mental Health Nurse Practitioner
  • Atlanta, GA
  • NPI 1033942537
  NPD (past)

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1235917469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 OAK GROVE ESTS NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303457601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NORTHEAST EXPY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303413932",
            "telephone_number": "404-435-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALLOWFORD WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-435-6604"
    },
    "taxonomies": [
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basheer Ahmed Shakir, MD
• Camille Shakir
• Pamela Denise Shakir, LCSW
• Khadija M Shalbi
• Shallowford Group Home
• Shalom Wellness Clinic
• Esther Yael Shalom
• Zouheir A Shama Sr., M.D
• Rebecca Leigh Shamah
• Luwi Joy Shamambo

• Community/Behavioral Health Agency in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.