Shaughn Reyenga, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

MSW008527 Issued in GA

Practice address

301 Green St NW Ste 100D
Gainesville, GA 30501-3361

Phone

(470) 508-9283

NPI assigned

Sep 12, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychiatric Professionals of Georgia, LLCGroup PAC ID 2567731482, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shaughn.reyenga.1@25899.direct.athenahealth.com

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.

• Psychiatric Professionals of Georgia, LLC

  • Psychiatry Physician
  • Suwanee, GA
  • NPI 1396277968
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1831976984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GREEN ST NW STE 100D",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013361",
            "telephone_number": "470-508-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GREEN ST NW STE 100D",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013361",
            "telephone_number": "470-508-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYENGA",
        "first_name": "SHAUGHN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW008527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renal Care Group Gainesville East, LLC
• Renal Care Group Gainesville, LLC
• Renal Treatment Centers Mid Atlantic Inc
• Laurice Dawn Repke
• Kristina Reus, PA
• Leslin Jackelin Reyes
• Stephanny Reyes, MD
• Nicholas Reynarowych, MEDICAL STUDENT
• Brittany Faye Reynolds
• Justin Michael Reynolds

• Social Worker in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.