Individual provider Active NPI

Shantel Brown, FNP

  • Family Nurse Practitioner
  • Dallas, GA
National Provider Identifier
1538717475
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
174530 Issued in GA
Practice address
495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone
(770) 445-2128
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 174530 GA Primary

Addresses

Primary practice location

495 Charles Hardy Pkwy
Dallas, GA 30157-5723

Mailing address

495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone (770) 445-2128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY, MD, OR4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230329000654 GA Practitioner - Nurse Practitioner 7618398975 Reassigns benefits to 3 organizations
I20251006000746 NY Practitioner - Nurse Practitioner 7618398975 Reassigns benefits to 1 organization
I20251014000533 MD Practitioner - Nurse Practitioner 7618398975 Reassigns benefits to 1 organization
I20251015001743 OR Practitioner - Nurse Practitioner 7618398975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4055 Valley View LN
Dallas, TX 75244-4910

4055 Valley View LN
Dallas, TX 75244-5074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174530GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 1, 2025 Accepting new patients
Grands Premier Health & Lab Diagnostics LLC Family CurrentSince Jan 1, 2022 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Sep 1, 2025 Accepting new patients
Minuteclinic LLC Family CurrentSince Mar 2, 2023 Accepting new patients
Monogram Health Professional Services PC Family CurrentSince Oct 20, 2025 Accepting new patients
Monogram Health Professional Services PC Family CurrentSince Oct 20, 2025 Accepting new patients
Regenerative Spine, Pain, and Neuropathy Centers, Inc. PastSince Jun 22, 2021 Accepting new patients
Lags Spine and Sportscare Medical Centers, Inc. Past Accepting new patients

Locations

3350 Riverwood Pkwy SE
Ste 1900
Atlanta, GA 30339
Phone (404) 277-2167

495 Charles Hardy Pkwy
Dallas, GA 30157
Phone (770) 231-4783

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 891-9833

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

2405 York Rd
Ste 201
Timonium, MD 21093
Phone (240) 332-4048

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

780 Commercial St SE
Ste 100
Salem, OR 97301
Phone (469) 466-7037

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1538717475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 CHARLES HARDY PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301575723",
            "telephone_number": "770-445-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CHARLES HARDY PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301575723",
            "telephone_number": "770-445-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHANTEL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "174530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.