Individual provider Active NPI

Shakaola Amaree Pinero, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Creek, GA
National Provider Identifier
1427310564
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP200869 Issued in GA
Practice address
10090 Medlock Bridge Rd
Johns Creek, GA 30097
Phone
(470) 482-6508
NPI assigned
Jun 14, 2012
Last updated
Jul 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN-NP200869 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-NP200869 GA Primary

Addresses

Primary practice location

10090 Medlock Bridge Rd
Johns Creek, GA 30097

Mailing address

2730 Peachtree Industrial Blvd Ste 105
#1130
Duluth, GA 30097
Phone (470) 489-4255

Other practice location 1

10090 Medlock Bridge Rd
Johns Creek, GA 30097
Phone (470) 482-6508

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120926000731 GA Practitioner - Nurse Practitioner 0648429134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

10090 Medlock Bridge Rd
Suite 110
Johns Creek, GA 30097-4428
Phone (470) 482-6508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP200869GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ubhs Inc Current Accepting new patients
Personal Recovery Network LLC CurrentSince Jun 17, 2019 Accepting new patients
Personal Recovery Network LLC PastSince Jun 17, 2019 Accepting new patients

Locations

10090 Medlock Bridge Rd
Ste 110
Johns Creek, GA 30097
Phone (470) 482-6508

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Interoperability endpoints

  • Direct secure messaging: gbh.shakaolapinero@124220.advancedmd-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1427310564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 PEACHTREE INDUSTRIAL BLVD STE 105",
            "address_2": "#1130",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "470-489-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 MEDLOCK BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "470-482-6508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10090 Medlock Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "30097",
            "country_code": "US",
            "telephone_number": "470-482-6508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINERO",
        "first_name": "SHAKAOLA",
        "middle_name": "AMAREE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "APRN-NP200869",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP200869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

Verify at the official NPI Registry.