Individual provider Active NPI

Scarlet Renee Shiflett, NP-C

  • Family Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1629743216
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07211218 Issued in GA
Practice address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone
(770) 279-6200
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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 F07211218 GA Primary

Addresses

Primary practice location

1626 Jeurgens CT
Norcross, GA 30093-2219

Mailing address

1601 Hooks Mill Rd
Leslie, GA 31764-2436
Phone (229) 881-9118

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221219000294 GA Practitioner - Nurse Practitioner 0143699918 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F07211218GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Physicians Services, LLC Family CurrentSince Sep 7, 2022 Accepting new patients
Community Care Health Network LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

441 Randall H Whiddon Dr
Ashburn, GA 31714
Phone (229) 567-3473

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

104 Monk St
Sylvester, GA 31791
Phone (229) 776-5541

Organizations & group practices 2

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1629743216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 HOOKS MILL RD",
            "city": "LESLIE",
            "state": "GA",
            "postal_code": "317642436",
            "telephone_number": "229-881-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFLETT",
        "first_name": "SCARLET",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F07211218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.