Shakeva Tiller, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN287171 Issued in GA

Practice address

135 Eagles Walk
Stockbridge, GA 30281-7206

Phone

(470) 726-4147

NPI assigned

Sep 5, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Heritage Care Place LLC

  • Professional Counselor
  • Stockbridge, GA
  • NPI 1124874425
  Medicare reassignment NPD
• Lotus Nest Counseling Services LLC

  • Marriage & Family Therapist
  • Americus, GA
  • NPI 1073129896
  Medicare reassignment NPD

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1255117271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531",
            "city": "MORELAND",
            "state": "GA",
            "postal_code": "302590531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 EAGLES WALK",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817206",
            "telephone_number": "470-726-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "SHAKEVA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN287171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yulando Hamilton Thornton
• Fredrick Antonia Thrasher, PHD, LPC, NCC
• Tiamoi Prestige Services LTD Co
• Tie on a Passer Surgical First Assisting LLC
• Tiffany Starnes Counseling Inc
• Davis Scott Timbert, M.D.
• Tiny Planet Counseling Inc
• Tiny Talkers Therapy Services, Inc.
• TLC Underground Trucking LLC
• Cherrele Antonyl Todd

• Psychiatric/Mental Health Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.