Individual provider Active NPI

Shevonda Nicole Butler

  • Nurse's Aide
  • Suwanee, GA
National Provider Identifier
1790585396
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0028861091 Issued in MI
Practice address
990 Peachtree Industrial Blvd Unit 913
Suwanee, GA 30024-5209
Phone
(470) 518-7273
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0028861091 MI Primary

Addresses

Primary practice location

990 Peachtree Industrial Blvd Unit 913
Suwanee, GA 30024-5209

Mailing address

990 Peachtree Industrial Blvd Unit 913
Suwanee, GA 30024-5209
Phone (470) 518-7273

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
CN0028861091MIMDNurse's Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Hearts of Compassion Healthcare LLC CurrentSince Mar 30, 2025 Accepting new patients

Locations

990 Peachtree Industrial Blvd
Unit 913
Suwanee, GA 30024
Phone (470) 518-7273

Organizations & group practices 1

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": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1790585396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 PEACHTREE INDUSTRIAL BLVD UNIT 913",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245209",
            "telephone_number": "470-518-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 PEACHTREE INDUSTRIAL BLVD UNIT 913",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245209",
            "telephone_number": "470-518-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "SHEVONDA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MI",
            "license": "CN0028861091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.