Shuwanda Nicole Gatlin

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

69 Ginntown Rd
Tylertown, MS 39667-5597

Phone

(601) 876-8779

NPI assigned

Dec 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• K & D Transportation Service LLC

  • Non-emergency Medical Transport (VAN)
  • Tylertown, MS
  • NPI 1598478869
  NPD Authorized official

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

{
    "created_epoch": "1672012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1831802669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396670511",
            "telephone_number": "601-876-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 GINNTOWN RD",
            "city": "TYLERTOWN",
            "state": "MS",
            "postal_code": "396675597",
            "telephone_number": "601-876-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLIN",
        "first_name": "SHUWANDA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920882044",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Health Care Clinic, Inc.
• Family Health Care Clinic, Inc.
• Family Medicine Associates, PA
• Yolanda Fortenberry, LPN
• Posavanike S Ganaraj, M.D.
• Harish M. Madnani M.D.P.C
• Hattiesburg Clinic, PA
• Chelsea Hill, FNP-C
• Carol Hobgood, F.N.P.
• Tanya Marie Holmes-Morris

• All providers in Tylertown, MS
• Driver in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.