Individual provider Active NPI

Shayna Adrianne Brathwaite

  • Vascular Surgery Physician
  • Decatur, GA
National Provider Identifier
1902162704
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
90021 Issued in GA
Practice address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone
(404) 321-6111
NPI assigned
Apr 5, 2012
Last updated
Mar 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 90021 GA Primary

Addresses

Primary practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Mailing address

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111

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
I20250707000072 GA Practitioner - Vascular Surgery 7214245117 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Healthcare, Inc. CurrentSince Apr 24, 2025 Accepting new patients

Locations

1800 Howell Mill Rd NW
Ste 250
Atlanta, GA 30318
Phone (404) 537-4910

720 Westview Dr SW
Atlanta, GA 30310
Phone (404) 756-1383

1670 Clairmont Rd
Decatur, GA 30033

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

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.

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1902162704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "SHAYNA",
        "middle_name": "ADRIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "90021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.