Individual provider Active NPI

Shanil Lara Harkins, MD

  • Gastroenterology Physician
  • Marietta, GA
National Provider Identifier
1821250267
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
071807 Issued in GA
Practice address
3747 Roswell Rd Ste 314
Marietta, GA 30062
Phone
(678) 741-5000
Fax
(770) 321-1318
NPI assigned
Jun 26, 2008
Last updated
May 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 071807 GA Primary

Addresses

Primary practice location

3747 Roswell Rd Ste 314
Marietta, GA 30062

Mailing address

711 Canton Rd NE Ste 300
Marietta, GA 30060-8949
Phone (678) 741-5000

Other identifiers 1

IdentifierTypeStateIssuer
003146414AMedicaidGA

Other names 1

  • Shanil Lara Rivera Former name

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
I20140729001026 GA Practitioner - Gastroenterology 7214153238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ponce School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Specialist of GeorgiaGroup PAC ID 9335032820, 35 clinicians

Practice addresses (Care Compare)

1121 Johnson Ferry Rd
Suite 150
Marietta, GA 30068-2791
Phone (678) 741-5000

118 Mill St
Suite 100
Woodstock, GA 30188-4880
Phone (678) 741-5000

118 Mill St
Suite 110
Woodstock, GA 30188-4812
Phone (678) 741-5000

2550 Windy Hill Rd SE
Marietta, GA 30067-8655
Phone (678) 741-5000

711 Canton Rd
Suite 300
Marietta, GA 30060-1136
Phone (678) 741-5000

711 Canton Rd NE
Suite 300
Marietta, GA 30060-8949
Phone (678) 741-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071807GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Specialist of Georgia Gastroenterology CurrentSince Jul 23, 2014 Accepting new patients

Locations

1700 Hospital South Dr
Ste 410
Austell, GA 30106
Phone (678) 741-2317

13 Reinhardt College Pkwy
#200
Canton, GA 30114

6002 Professional Pkwy
Ste 200
Douglasville, GA 30134
Phone (770) 942-0457

148 Bill Carruth Pkwy
Ste 200
Hiram, GA 30141

880 Crestmark Dr
Ste 102
Lithia Springs, GA 30122
Phone (678) 388-2040

1121 Johnson Ferry Rd
Ste 150
Marietta, GA 30068
Phone (770) 977-1510

2550 Windy Hill Rd SE
Ste 302
Marietta, GA 30067
Phone (678) 574-0943

2550 Windy Hill Rd SE
Ste 307
Marietta, GA 30067
Phone (770) 953-1414

3747 Roswell Rd
Ste 314
Marietta, GA 30062
Phone (770) 424-4328

711 Canton Rd NE
Ste 300
Marietta, GA 30060
Phone (678) 741-2317

1357 Hembree Rd
Ste 240
Roswell, GA 30076
Phone (404) 446-3600

118 Mill St
Ste 100
Woodstock, GA 30188
Phone (678) 741-2317

118 Mill St
Ste 110
Woodstock, GA 30188
Phone (678) 607-2264

Interoperability endpoints

  • Direct secure messaging: shanil.harkins@gsg.eclinicaldirectplus.com

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1821250267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CANTON RD NE STE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608949",
            "telephone_number": "678-741-5000",
            "fax_number": "678-819-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3747 ROSWELL RD STE 314",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30062",
            "telephone_number": "678-741-5000",
            "fax_number": "770-321-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKINS",
        "first_name": "SHANIL",
        "middle_name": "LARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "071807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003146414A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANIL",
            "last_name": "LARA RIVERA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.