Shanice Thurmond, PA-C

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

9934 Issued in GA

Practice address

2201 Talmadge Rd
Hampton, GA 30228-1608

Phone

(404) 564-7005

NPI assigned

Jul 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanice.thurmond.p1@direct.smcmed.nextgenshare.com

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.

• Southside Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1235123993
  Medicare reassignment NPD
• Southside Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jonesboro, GA
  • NPI 1821981234
  NPD

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1336793710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6558 ROSWELL RD APT 1168",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285071",
            "telephone_number": "414-698-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 TALMADGE RD",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281608",
            "telephone_number": "404-564-7005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Upper Riverdale Rd SW",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742527",
            "country_code": "US",
            "telephone_number": "404-564-7005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURMOND",
        "first_name": "SHANICE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven K. Taylor, O.D.
• The Georgia Center for Youth and Families, Inc.
• Thembrowns Cares Transportation LLC
• Patricia Thompson
• Malcolm Thorpe
• Touching Souls LLC
• Porche Travis
• Tribridge Home Health Solutions, LLC
• Tribridge Home Health Solutions, LLC
• Kadiatu Tricket

• Obstetrics & Gynecology Physician in Hampton, GA
• Providers in Hampton, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.