Shelba Jean Thiel, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN076354 Issued in GA

Practice address

1394 Abbie Kilgore Way
Loganville, GA 30052-7580

Phone

(770) 985-0498

NPI assigned

Jan 12, 2007

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

Other names 1

• Mrs. Jeannie Thiel Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vision Medical Consulting, P.C.

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1073562922
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1265583710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 ABBIE KILGORE WAY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527580",
            "telephone_number": "770-985-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 ABBIE KILGORE WAY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527580",
            "telephone_number": "770-985-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "SHELBA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN076354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNIE",
            "last_name": "THIEL",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Nurse Practitioner in Loganville, GA
• Providers in Loganville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.