Kelley C Shaw, C.P.N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN171700 Issued in GA

Practice address

3400A Old Milton Pkwy Ste 330
Alpharetta, GA 30005-4438

Phone

(770) 751-6111

Fax

(770) 772-6099

NPI assigned

Nov 28, 2011

Last updated

Nov 28, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Pediatrics, LLC

  • Pediatrics Physician
  • Atlanta, GA
  • NPI 1710003520
  NPD (past)

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1356618912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400A OLD MILTON PKWY STE 330",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054438",
            "telephone_number": "770-751-6111",
            "fax_number": "770-772-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400A OLD MILTON PKWY STE 330",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054438",
            "telephone_number": "770-751-6111",
            "fax_number": "770-772-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KELLEY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN171700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Andrew Shapira, M.D., PH.D.
• Ramla Sharif, M.D.
• Julie M Sharp, LAPC
• Nicholas Shashy
• Courtney Shaw
• Paula Shaw
• Conrad William Shebelut, MD
• Naima Shegow
• Shelland (Childrens Therapy Works)
• David Kenneth Shellington, M.D.

• Nurse Practitioner in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.