Shenelle LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

SHENELLE LLC

Practice address

3670 McClure Bridge Rd
Ste 4141
Duluth, GA 30096-1445

Phone

(866) 556-8670

NPI assigned

Sep 5, 2013

Last updated

Sep 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Prof. Bernard Evans

Title

Chief Executive Officer

Phone

(877) 373-9600

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1255766572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44445",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303361445",
            "telephone_number": "877-373-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 MCCLURE BRIDGE RD",
            "address_2": "STE 4141",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961445",
            "telephone_number": "866-556-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENELLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "877-373-9600",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roslyn Shamsi
• Alexus Jennivie Shaw
• Mark L Shefrin, DMD
• Jennifer Leigh Shelato, CF-SLP
• Timothy Lee Shelton, M.D.
• Wesley Scott Sherrell, D.M.D.
• Tatiana Shifrin, DMD
• Young Tae Shim, DMD
• Dong Pyo Shin, L.AC
• Dongwoo Shin

• Custodial Care Facility in Duluth, GA
• Providers in Duluth, GA by specialty
• Custodial Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.