Individual provider Active NPI

Shalia Shani Gregory, FNP-C

  • Family Nurse Practitioner
  • Tucker, GA
National Provider Identifier
1275964447
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN201437 Issued in GA
Practice address
4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905
Phone
(404) 692-4466
Fax
(415) 252-7176
NPI assigned
Dec 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN201437 GA
Family Nurse Practitioner 363LF0000X RN201437 GA Primary

Addresses

Primary practice location

4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905

Mailing address

4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905
Phone (404) 692-4466

Other practice location 1

1230 Peachtree St NE
Atlanta, GA 30309-3574
Phone (866) 949-0108

Other practice location 2

2712 Lawrenceville Hwy
Decatur, GA 30033-2512
Phone (770) 496-5555

Other identifiers 1

IdentifierTypeStateIssuer
003142568EMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140319000645 GA Practitioner - Nurse Practitioner 8224269196 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN201437GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC Current Accepting new patients
Iora Senior Health, LLC CurrentSince Mar 24, 2025 Accepting new patients
Iora Senior Health, LLC CurrentSince Mar 24, 2025 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Jan 7, 2026 Accepting new patients
Monogram Health Professional Services PC Nurse Practitioner CurrentSince Jan 7, 2026 Accepting new patients
DL Howard MD PHD PLLC Past Accepting new patients
Northside Imaging LLC Past Accepting new patients
NSH Cancer Institute Professional Services G, LLC Past Accepting new patients

Locations

1 Embarcadero Ctr
Fl 19
San Francisco, CA 94111
Phone (415) 814-0927

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 277-2167

3527 Memorial Dr
Unit W
Decatur, GA 30032
Phone (404) 573-4844

4424 Hugh Howell Rd
Ste D
Tucker, GA 30084
Phone (404) 692-4466

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1275964447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 HUGH HOWELL RD STE D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844905",
            "telephone_number": "404-692-4466",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 HUGH HOWELL RD STE D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844905",
            "telephone_number": "404-692-4466",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1230 Peachtree St NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303093574",
            "country_code": "US",
            "telephone_number": "866-949-0108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2712 Lawrenceville Hwy",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300332512",
            "country_code": "US",
            "telephone_number": "770-496-5555",
            "fax_number": "770-939-2887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "SHALIA",
        "middle_name": "SHANI",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-12",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN201437",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN201437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003142568E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.