Active NPI
Cassandra Shields
- Prosthetics Case Management
- Atlanta, GA
National Provider Identifier
1689043127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- CO084506
- Practice address
- 275 Carpenter Dr
Suite 350
Atlanta, GA 30328-4928 - Phone
- (404) 549-3936
- NPI assigned
- Sep 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | RC75004 | SC | |
| Prosthetics Case Management | 1744P3200X | CO084506 | GA | Primary |
Addresses
Primary practice location
275 Carpenter Dr
Suite 350
Atlanta, GA 30328-4928
Mailing address
110 Walter Way
1693
Stockbridge, GA 30281-9533
Phone (404) 587-4412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO084506 | GA | MD | Prosthetics Case Management |
| RC75004 | SC | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1689043127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WALTER WAY",
"address_2": "1693",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302819533",
"telephone_number": "404-587-4412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 CARPENTER DR",
"address_2": "SUITE 350",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303284928",
"telephone_number": "404-549-3936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "CASSANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-15",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "SC",
"license": "RC75004",
"primary": false
},
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "GA",
"license": "CO084506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.