Individual provider Active NPI

Shuntina Lenette Lilly, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1619320306
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN186067 Issued in GA
Practice address
5555 Whittlesey Blvd Ste 1200
Columbus, GA 31909-7234
Phone
(706) 621-7532
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN186067 GA Primary

Addresses

Primary practice location

5555 Whittlesey Blvd Ste 1200
Columbus, GA 31909-7234

Mailing address

3394 Cooper Branch Rd
Columbus, GA 31909-2321
Phone (706) 405-6980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX, IA, NY4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20171127001607 GA Practitioner - Nurse Practitioner 2769749902 Reassigns benefits to 6 organizations
I20260407003160 TX Practitioner - Nurse Practitioner 2769749902 Reassigns benefits to 1 organization
I20260420001680 IA Practitioner - Nurse Practitioner 2769749902 Reassigns benefits to 1 organization
I20260605003768 NY Practitioner - Nurse Practitioner 2769749902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-2303

Hospital & facility affiliations

  • St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN186067GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 16, 2017 Accepting new patients
Benning Hospitalist Services, LLC CurrentSince Jan 1, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Oct 16, 2017 Accepting new patients
Muscogee Hospitalist Services, LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

200 Medical Dr
Lagrange, GA 30240
Phone (706) 803-7180

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1619320306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3394 COOPER BRANCH RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092321",
            "telephone_number": "706-405-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 WHITTLESEY BLVD STE 1200",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319097234",
            "telephone_number": "706-621-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "SHUNTINA",
        "middle_name": "LENETTE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN186067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.