Individual provider Active NPI

Andrea Shane, MD, MPH

  • Pediatric Infectious Diseases Physician
  • Atlanta, GA
National Provider Identifier
1811959356
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
58010 Issued in GA
Practice address
1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Phone
(404) 785-5437
Fax
(404) 785-9111
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 58010 GA Primary

Addresses

Primary practice location

1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309

Mailing address

1400 Tullie Rd NE FL 2
Atlanta, GA 30329-2309
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000041 GA Practitioner - Infectious DiseasePractitioner - Pediatric Medicine 7416951546 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Hospital Based, LLC Current Accepting new patients
Egleston Pediatric Group Current Accepting new patients
Choa Multispecialty, LLC Pediatric Infectious Diseases CurrentSince Jul 1, 2013 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 30, 2007 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Sep 30, 2007 Accepting new patients
Emory Childrens Center Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2015 Upper Gate Dr NE
Atlanta, GA 30322
Phone (404) 778-2400

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Interoperability endpoints

  • Direct secure messaging: ashane15142@choa.gadirect.net

Organizations & group practices 6

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1811959356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "ANDREA",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "GA",
            "license": "58010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1400 Tullie Rd NE Fl 2",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303292309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.