Individual provider Active NPI

John Judson Shelnutt, M.D.

  • Obstetrics & Gynecology Physician
  • Athens, GA
National Provider Identifier
1407823719
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
046813 Issued in GA
Practice address
1500 Oglethorpe Ave
Suite 200B
Athens, GA 30606-2179
Phone
(706) 227-1164
Fax
(706) 227-1971
NPI assigned
Mar 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 046813 GA Primary

Addresses

Primary practice location

1500 Oglethorpe Ave
Suite 200B
Athens, GA 30606-2179

Mailing address

1500 Oglethorpe Ave
Suite 200B
Athens, GA 30606-2179
Phone (706) 227-1164

Other identifiers 1

IdentifierTypeStateIssuer
000827197AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101124000013 GA Practitioner - Obstetrics/Gynecology 9931395373 Reassigns benefits to 1 organization
I20220921000405 GA Practitioner - Obstetrics/Gynecology 9931395373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Georgia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sas Womens Healthcare LLCGroup PAC ID 2961705090, 2 clinicians

Practice addresses (Care Compare)

1000 Hawthorne Ave
Athens, GA 30606-2168
Phone (706) 286-8694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shelnutt Obstetrics & Gynecology Obstetrics & Gynecology CurrentSince Jul 1, 1999 Accepting new patients

Locations

1500 Oglethorpe Ave
Ste 200B
Athens, GA 30606
Phone (706) 227-1164

Interoperability endpoints

  • Direct secure messaging: john.shelnutt@shelnettobgyn.gadirect.net

Organizations & group practices 2

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": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1407823719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 200B",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-227-1164",
            "fax_number": "706-227-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 OGLETHORPE AVE",
            "address_2": "SUITE 200B",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062179",
            "telephone_number": "706-227-1164",
            "fax_number": "706-227-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELNUTT",
        "first_name": "JOHN",
        "middle_name": "JUDSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-06",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "046813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000827197A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.