NPIMap

Organization Active NPI

Shining Light Behavior Health Services

  • Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1447136122
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SHINING LIGHT BEHAVIOR HEALTH SERVICES
Practice address
1523 Great Shoals Cir
Lawrenceville, GA 30045-7098
Phone
(404) 800-0397
NPI assigned
Aug 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Reginald DrumgooleNPI 1689743270
Title
Owner
Phone
(404) 800-0397

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

1523 Great Shoals Cir
Lawrenceville, GA 30045-7098

Mailing address

1523 Great Shoals Cir
Lawrenceville, GA 30045-7098
Phone (404) 800-0397

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1447136122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 GREAT SHOALS CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457098",
            "telephone_number": "404-800-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 GREAT SHOALS CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457098",
            "telephone_number": "404-800-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING LIGHT BEHAVIOR HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "DRUMGOOLE",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-800-0397"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.