Shawna M Berg, FNP
Individual provider Active NPI Nurse Practitioner · Carrollton, GA
NPI 1598047730 · NPPES record last updated Mar 21, 2025
Key facts
- NPI
- 1598047730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN113194 (GA)
- Practice address
- 820 Maple St
Carrollton, GA 30117-3626 - Phone
- (678) 390-7915
- Fax
- (678) 390-7901
- NPI assigned
- Sep 14, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111011000114 | GA | Practitioner - Nurse Practitioner | 7911179221 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN113194 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMC Immediate Care, Inc | Current |
Accepting new patients | |
| Tanner Medical Group Inc | Current |
Accepting new patients | |
| 316 Family Medicine | Current |
Accepting new patients | |
| Peachtree Immediate Care FP, LLC | Current |
Accepting new patients | |
| 3:16 Urgent Care LLC | Current |
Accepting new patients | |
| Tanner Family Healthcare of Franklin Inc | Current | Accepting new patients | |
| Carrollton Surgical Group, P. a. | Past |
Accepting new patients |
Locations
1125 E Highway 166
Bowdon, GA 30108
Phone (770) 258-5424
222 Gordon St
Bremen, GA 30110
Phone (770) 537-1234
1009 Alabama Ave S
Bremen, GA 30110
Phone (678) 821-1660
1131 Bankhead Hwy
Carrollton, GA 30116
Phone (678) 890-7648
109 Professional Pl
Carrollton, GA 30117
Phone (770) 834-0170
119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710
1480 S Highway 27
Carrollton, GA 30117
Phone (770) 812-9445
820 Maple St
Carrollton, GA 30117
Phone (678) 390-7900
590 Lanier Ave W
Fayetteville, GA 30214
2906 Franklin Pkwy
Franklin, GA 30217
Phone (706) 675-6949
3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900
690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646
101 Quartz Dr
Ste 101
Villa Rica, GA 30180
Phone (770) 836-9445
Interoperability endpoints
- shawna.berg.1@22071.direct.athenahealth.com
- https://api.platform.athenahealth.com/22071/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN113194 | GA | |
| Nurse Practitioner | 363L00000X | RN113194 | GA | Yes |
Addresses
Primary practice location
820 Maple St
Carrollton, GA 30117-3626
Mailing address
222 Gordon St
Bremen, GA 30110-1519
Phone (770) 537-1234
Other practice location 1
1009 Alabama Ave S
Bremen, GA 30110-2501
Phone (678) 821-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861915647 | Other | GA | GROUP NPI |
Other names
- Shawna M Poulnott
Other providers in Carrollton, GA
- Scott Benefield
- April Denise Benton
- Adrienne Simone Berard
- William Ronald Berard
- Mary Bereznak
- Amy Bergquist
- Garland Keith Berry
- Marian Adale Berry
- Bailey Andrews Bevil
- Latoya Pulliam Bexley
All providers in Carrollton, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.