Shawn Green, ACNS-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

16635 Issued in TN

Practice address

1314 Concord Rd SE
Smyrna, GA 30080-4361

Phone

(770) 438-1799

Fax

(770) 825-9046

NPI assigned

Aug 19, 2016

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Male

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 TN, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Safe Haven Health LLC

  • Psychiatric/Mental Health Registered Nurse
  • Brentwood, TN
  • NPI 1629645288

  Multi-Specialty

  Medicare reassignment NPD Authorized official
• Georgia Psychiatry & Sleep

  • Psychiatry Physician
  • Smyrna, GA
  • NPI 1558516997

  Multi-Specialty

  Medicare reassignment NPD
• Brave Health Medical Group PA

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1225669161

  GA, Multi-Specialty

  Medicare reassignment NPD
• Psych Atlanta, P.C.

  • Psychiatry Physician
  • Marietta, GA
  • NPI 1184756090

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1356896377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 ECHELON LN",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802126",
            "telephone_number": "404-435-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 CONCORD RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804361",
            "telephone_number": "770-438-1799",
            "fax_number": "770-825-9046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Continental Pl",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370271041",
            "country_code": "US",
            "telephone_number": "615-488-3121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHAWN",
        "credential": "ACNS-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2024-06-26",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "16635",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TN",
            "license": "16635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilletta H. Gray, R.PH.
• Graydots International Concepts
• Great Oak Counseling
• Adrian NMN Green
• Lamonica Green, LPC
• Kim McPherson Greene, RN, ED.D..
• Whitley Greene, LPC
• Jamie Annette Grice
• Anna Griffin, R PH
• Sherwood O Griggs Sr., CSA

• Psychiatric/Mental Health Nurse Practitioner in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.