Active NPI
Phyllis Shanyisa Shiluli
- Family Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1336741982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F05180369
- Practice address
- 3100 Sugarberry LN
Atlanta, GA 30339-8567 - Phone
- (770) 843-0504
- NPI assigned
- Nov 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F05180369 | GA | Primary |
Addresses
Primary practice location
3100 Sugarberry LN
Atlanta, GA 30339-8567
Mailing address
3100 Sugarberry LN
Atlanta, GA 30339-8567
Phone (770) 843-0504
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
725 Relay Rd
Angoon, AK 99820-1277
Phone (907) 788-7600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F05180369 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Norton Sound Health Corporation | Current | Accepting new patients |
Locations
3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000
222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423
Organizations & group practices 6
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.
-
- Critical Access Hospital
- Nome, AK
- NPI 1154358232
-
- Critical Access Hospital
- Nome, AK
- NPI 1225101041
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Nome, AK
- NPI 1427187046
-
- Clinic/Center
- Juneau, AK
- NPI 1427941343
-
- Clinic/Center
- Port Protection, AK
- NPI 1962948356
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Nome, AK
- NPI 1225101041
-
- Clinic/Center
- Tenakee Springs, AK
- NPI 1477721280
Hospital
-
- Nursing Facility/Intermediate Care Facility
- Juneau, AK
- NPI 1932312485
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1336741982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SUGARBERRY LN",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303398567",
"telephone_number": "770-843-0504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SUGARBERRY LN",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303398567",
"telephone_number": "770-843-0504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHILULI",
"first_name": "PHYLLIS",
"middle_name": "SHANYISA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "F05180369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.