Individual provider Active NPI

Shalunda Harrison

  • Licensed Practical Nurse
  • Decatur, GA
National Provider Identifier
1700495975
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN078786 Issued in GA
Practice address
4311 Christine CT
Decatur, GA 30035-1702
Phone
(470) 651-0956
NPI assigned
Jul 23, 2020
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN078786 GA Primary

Addresses

Primary practice location

4311 Christine CT
Decatur, GA 30035-1702

Mailing address

4311 Christine CT
Decatur, GA 30035-1702
Phone (470) 651-0956

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL email Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
LPN078786GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
An Angels Touch Hospice LLLP Current Accepting new patients
An Angel's Touch Personal Care Solut and Hospice Services, LLC CurrentSince Dec 1, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1700495975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 CHRISTINE CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351702",
            "telephone_number": "470-651-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 CHRISTINE CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300351702",
            "telephone_number": "470-651-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "SHALUNDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN078786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4311 Christine Ct",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300351702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.