Glenn Clinton Shedd, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN117525 Issued in GA

Practice address

330 Hawthorne LN
Athens, GA 30606-2152

Phone

(706) 613-8500

Fax

(706) 613-8844

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1720074339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603725",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603725",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HAWTHORNE LN",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062152",
            "telephone_number": "706-613-8500",
            "fax_number": "706-613-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "GLENN",
        "middle_name": "CLINTON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN117525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I507833",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000804427B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylee Ann Shaver, ATC
• Angela Shaw, LMSW
• Eleonor Shaw
• Mariah Power Shearer, LPC, NCC
• Brianna Nicole Sheats
• Austin Shedden, PSY D
• Philip Anderson Sheffield, M.D.
• Shelnutt Obstetrics & Gynecology
• John Judson Shelnutt, M.D.
• Edward N Shelton, PA

• Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.