Shannon Leigh Whitwell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN159448 Issued in GA

Practice address

1100 W Lake Commons Dr
Martinez, GA 30907-7932

Phone

(706) 228-2565

Fax

(706) 868-1405

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Augusta Anti-Aging Medicine, LLCGroup PAC ID 3971903733, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Augusta Anti-Aging Medicine, LLC

  • Family Nurse Practitioner
  • Evans, GA
  • NPI 1568047876
  Medicare reassignment Care Compare group NPD
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046
  Medicare reassignment NPD
• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1336413954
  NPD
• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1871885806
  NPD
• University Primary Care

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1124231808
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1437619277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-8326",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W LAKE COMMONS DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309077932",
            "telephone_number": "706-228-2565",
            "fax_number": "706-868-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3851 Evans To Locks Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "GA",
            "postal_code": "309075073",
            "country_code": "US",
            "telephone_number": "706-228-2565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITWELL",
        "first_name": "SHANNON",
        "middle_name": "LEIGH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "F02191114",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN159448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "F02191114",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "159448",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylynn Warthen
• Eva Watkins, RN
• Kathryn A Webb, DC
• Westlond Recovery and Holistic Counseling Center
• Susan E. Whitaker, M.ED. CCC-SLP
• Christine Wieberdink, CPM, LM
• Lolita D Wiggs, MS, LPC
• William Ferguson DMD PC
• Ashley Williams Morris
• Aleeka Williams, BCBA

• Family Nurse Practitioner in Martinez, GA
• Providers in Martinez, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.