Active NPI
Susan Shadix, LMSW
- Social Worker
- Athens, GA
National Provider Identifier
1447608880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW002972
- Practice address
- 250 North Ave
Athens, GA 30601-2244 - Phone
- (706) 389-6789
- Fax
- (706) 224-7249
- NPI assigned
- May 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW002972 | GA | Primary |
Addresses
Primary practice location
250 North Ave
Athens, GA 30601-2244
Mailing address
250 North Ave
Athens, GA 30601-2244
Phone (706) 389-6789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW002972 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464220800000",
"number": "1447608880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 NORTH AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306012244",
"telephone_number": "706-389-6789",
"fax_number": "706-224-7249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 NORTH AVE",
"city": "ATHENS",
"state": "GA",
"postal_code": "306012244",
"telephone_number": "706-389-6789",
"fax_number": "706-224-7249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHADIX",
"first_name": "SUSAN",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-26",
"last_updated": "2016-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW002972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.