Shannon Mize, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

018866 Issued in GA

Practice address

208 Hudson Street
Cumming, GA 30040-2432

Phone

(770) 889-2090

Fax

(770) 781-4373

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Medical College of Georgia School of Medicine, 1976

Medicare assignment

May accept Medicare assignment

Group practices

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tugaloo Home Health Agency, an Amedisy Company Home health agency, Gainesville, GA, CCN 117305
• Accentcare Home Health of Northeast Georgia Home health agency, Buford, GA, CCN 117139
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: shannon.mize.1@12267.direct.athenahealth.com

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.

• Thomas Lifetime Health LLC

  • Family Medicine Physician
  • Lawrenceville, GA
  • NPI 1265137822
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Gainesville, GA
  • NPI 1912955667
  Care Compare affiliation
• Guardian Home Care of Northeast Georgia, LLC

  • Home Health Agency
  • Buford, GA
  • NPI 1639100985
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1609885813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HUDSON STREET",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402432",
            "telephone_number": "770-889-2090",
            "fax_number": "770-781-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HUDSON STREET",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402432",
            "telephone_number": "770-889-2090",
            "fax_number": "770-781-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZE",
        "first_name": "SHANNON",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "018866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000179803B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00179803B1",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen K Mitchell, MD
• Kelsey Morgan Mitchell
• Lauren Mitchell, M.S.,CF-SLP
• Lisa Robin Mitchell, LMSW
• Natalie Nicole Mitchell, NP
• Adrienne Moberg, LCSW
• Bansari Modi
• Farid Moghaddam, D.M.D.
• Moghniuddin Mohammed, M.D.
• Lisa Marie Mohesky, ORT/L

• Family Medicine Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.

Verify at the official NPI Registry.