Individual provider Active NPI

Shemiko McInnis, WHNP-BC

  • Women's Health Nurse Practitioner
  • Smyrna, GA
National Provider Identifier
1568101665
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN269311 Issued in GA
Practice address
3200 Highlands Pkwy SE Ste 420
Smyrna, GA 30082-5192
Phone
(678) 424-1123
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN269311 GA Primary
Emergency Registered Nurse 163WE0003X RN269311 GA

Addresses

Primary practice location

3200 Highlands Pkwy SE Ste 420
Smyrna, GA 30082-5192

Mailing address

3645 Habersham Rd NE Apt 307
Atlanta, GA 30305-6204
Phone (601) 270-1632

Other practice location 1

1520 Clifton Rd NE
Atlanta, GA 30322-4201
Phone (404) 727-7980

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN269311GAMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Urgyn, LLC Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shemiko.mcinnis.1@31744.direct.athenahealth.com

Organizations & group practices 1

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": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1568101665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 HABERSHAM RD NE APT 307",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303056204",
            "telephone_number": "601-270-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HIGHLANDS PKWY SE STE 420",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825192",
            "telephone_number": "678-424-1123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303224201",
            "country_code": "US",
            "telephone_number": "404-727-7980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "SHEMIKO",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2023-12-22",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN269311",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "GA",
            "license": "RN269311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.