Active NPI
Shana B Deloach, CNM
- Advanced Practice Midwife
- Athens, GA
National Provider Identifier
1609218601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- RN216236
- Practice address
- 242 King Avenue Ste 120
Athens, GA 30606 - Phone
- (706) 475-5700
- NPI assigned
- Jul 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | RN216236 | GA | |
| Advanced Practice Midwife | 367A00000X | RN216236 | GA | Primary |
Addresses
Primary practice location
242 King Avenue Ste 120
Athens, GA 30606
Mailing address
242 King Avenue Ste 120
Athens, GA 30606
Phone (706) 475-5700
Other practice location 1
79 E Doyle St
Toccoa, GA 30577
Phone (706) 282-7676
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003142037M | Medicaid | GA | |
| 04702359 | Other | GA | AMERIGROUP |
| 003142037N | Medicaid | GA | |
| 003142037J | Medicaid | GA | |
| 003142037K | Medicaid | GA | |
| 003142037L | Medicaid | GA | |
| 003142037O | Medicaid | GA | |
| 1368524 | Other | GA | WELLCARE |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 89.1 of 100
- Quality
- 87.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN216236 | GA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Athens Specialty Care LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Piedmont Athens Hospitalist Physicians LLC | Current | Accepting new patients | |
| Piedmont Athens Regional Medical Center, Inc. | Past | Accepting new patients | |
| Robert B Raybon Et Al PTR | Advanced Practice Midwife | Past | Accepting new patients |
| Athens Area Urology, PC | Past | Accepting new patients |
Locations
1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520
340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1578079000
-
- Cardiovascular Disease Physician
- Athens, GA
- NPI 1184130627
Obstetrics & Gynecology
-
- Urology Physician
- Watkinsville, GA
- NPI 1578803755
-
- General Acute Care Hospital
- Athens, GA
- NPI 1437186111
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752278400000",
"number": "1609218601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 KING AVENUE STE 120",
"city": "ATHENS",
"state": "GA",
"postal_code": "30606",
"telephone_number": "706-475-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 KING AVENUE STE 120",
"city": "ATHENS",
"state": "GA",
"postal_code": "30606",
"telephone_number": "706-475-5700"
}
],
"practiceLocations": [
{
"address_1": "79 E Doyle St",
"address_purpose": "LOCATION",
"city": "Toccoa",
"state": "GA",
"postal_code": "30577",
"country_code": "US",
"telephone_number": "706-282-7676",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DELOACH",
"first_name": "SHANA",
"middle_name": "B",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-19",
"last_updated": "2025-07-12",
"certification_date": "2025-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "GA",
"license": "RN216236",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "GA",
"license": "RN216236",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037M",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "04702359",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037N",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037J",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037K",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037L",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003142037O",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "1368524",
"state": "GA"
}
],
"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 Jul 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.