Shelley Smith, AGPC-NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN106235 Issued in GA

Practice address

6001 Professional Pkwy Ste 2080
Douglasville, GA 30134-5632

Phone

(678) 715-5080

NPI assigned

Aug 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1369/brand/1/csg/1/fhir/r4

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333
  Medicare reassignment NPD
• Lifetime Family Medicine,LLC

  • Family Medicine Physician
  • Dallas, GA
  • NPI 1053509216
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• West Georgia Cardiology Associates, PC

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1932421187
  Medicare reassignment
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Temple Medical LLC

  dba TempleMed Health

  • Family Medicine Physician
  • Villa Rica, GA
  • NPI 1740406438
  NPD (past)

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1881149102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 PROFESSIONAL PKWY STE 2080",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345632",
            "telephone_number": "678-715-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 PROFESSIONAL PKWY STE 2080",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345632",
            "telephone_number": "678-715-5080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Bankhead Hwy",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "GA",
            "postal_code": "301173425",
            "country_code": "US",
            "telephone_number": "770-838-8440",
            "fax_number": "678-839-7293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELLEY",
        "credential": "AGPC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN106235",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN106235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Marie Smith, MED, LPC
• Michele Lyons Smith, ND
• Natyshia Smith, DSW, LMSW, LSWAIC
• Roticia Smith
• Samantha Smith, PHARMD
• Solomon Smith
• Susan Bird Smith, AGACNP-BC
• Trevor Craig Smith, M.D.
• Aubri Simone Snell
• Rachel Sohnen, NP

• Gerontology Nurse Practitioner in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.