Individual provider Active NPI

Shana B Deloach, CNM

  • Advanced Practice Midwife
  • Athens, GA
National Provider Identifier
1609218601
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN216236 Issued in GA
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

Updated by the provider on Jul 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
003142037MMedicaidGA
04702359OtherGAAMERIGROUP
003142037NMedicaidGA
003142037JMedicaidGA
003142037KMedicaidGA
003142037LMedicaidGA
003142037OMedicaidGA
1368524OtherGAWELLCARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023000846 GA Practitioner - Certified Nurse Midwife (CNM) 5496980757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.1 of 100Reported as group
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

LicenseStateTypeSpecialty
RN216236GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Specialty Care LLC Obstetrics & Gynecology CurrentSince Dec 30, 2024 Accepting new patients
Piedmont Athens Hospitalist Physicians LLC CurrentSince Dec 30, 2024 Accepting new patients
Piedmont Athens Regional Medical Center, Inc. Past Accepting new patients
Robert B Raybon Et Al PTR Advanced Practice Midwife PastSince Mar 15, 2000 Accepting new patients
Athens Area Urology, PC PastSince Dec 30, 2024 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.

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

Verify at the official NPI Registry.