Individual provider Active NPI

Shannon Jean Hemenway, APRN, ANP-BC

  • Adult Health Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1467661264
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN180038NP Issued in GA
Practice address
3226 Hampton Ave Ste a
Brunswick, GA 31520-4226
Phone
(912) 264-0760
NPI assigned
May 21, 2007
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN180038NP GA Primary

Addresses

Primary practice location

3226 Hampton Ave Ste a
Brunswick, GA 31520-4226

Mailing address

3226 Hampton Ave Ste a
Brunswick, GA 31520-4226
Phone (912) 264-0760

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
I20120613000703 GA Practitioner - Nurse Practitioner 0244494763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1506 Alice St
Waycross, GA 31501-4531
Phone (912) 285-3087

3226 Hampton Ave
Suite a
Brunswick, GA 31520-4226
Phone (912) 264-0760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN180038NPGAMDAdult Health Nurse Practitioner
SP007080PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Oct 6, 2021 Accepting new patients
Coastal Cardiology PC CurrentSince Aug 1, 1997 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 6, 2021 Accepting new patients

Locations

3226 Hampton Ave
Ste A
Brunswick, GA 31520
Phone (912) 264-0760

1506 Alice St
Waycross, GA 31501
Phone (912) 285-3086

Interoperability endpoints

  • Direct secure messaging: shannon.hemenway.1@8967.direct.athenahealth.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1467661264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 HAMPTON AVE STE A",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204226",
            "telephone_number": "912-264-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 HAMPTON AVE STE A",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204226",
            "telephone_number": "912-264-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMENWAY",
        "first_name": "SHANNON",
        "middle_name": "JEAN",
        "credential": "APRN, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN180038NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.