Active NPI
Shantrella Penson, NP
- Family Nurse Practitioner
- McDonough, GA
National Provider Identifier
1720991250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP289400
- Practice address
- 325 Huntington PL CT
McDonough, GA 30253 - Phone
- (678) 782-6920
- NPI assigned
- Sep 25, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP289400 | GA | Primary |
Addresses
Primary practice location
325 Huntington PL CT
McDonough, GA 30253
Mailing address
885 Hall St
Macon, GA 31217-6456
Phone (478) 538-2440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790294400000",
"number": "1720991250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "885 HALL ST",
"city": "MACON",
"state": "GA",
"postal_code": "312176456",
"telephone_number": "478-538-2440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 HUNTINGTON PL CT",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "30253",
"telephone_number": "678-782-6920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENSON",
"first_name": "SHANTRELLA",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "NP289400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.