Shanta Lacole Clayton, RN

Key facts

NPI

1831699586

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

RN251414 (GA)

Practice address

127 Rowland Dr Unit C
Moultrie, GA 31768-4120

Phone

(229) 891-3198

Fax

(229) 616-4224

NPI assigned

Feb 20, 2018

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Daisy Concierge Care Nursing Care Agency · Moultrie, GA · NPI 1326697731
  NPD Authorized official
• Pink Penny Care, LLC In Home Supportive Care Agency · Moultrie, GA · NPI 1104329689
  NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Nurse

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2026.

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1831699586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 ROWLAND DR UNIT C",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317684120",
            "telephone_number": "229-891-3198",
            "fax_number": "229-616-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ROWLAND DR UNIT C",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317684120",
            "telephone_number": "229-891-3198",
            "fax_number": "229-616-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "SHANTA",
        "middle_name": "LACOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN251414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Moultrie, GA · Registered Nurse in Georgia