Individual provider Active NPI

Shawanda Terry

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1912867789
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-189727 Issued in AL
Practice address
2000 16TH Ave
Columbus, GA 31901-1665
Phone
(706) 320-3700
NPI assigned
Nov 14, 2025
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-189727 AL Primary

Addresses

Primary practice location

2000 16TH Ave
Columbus, GA 31901-1665

Mailing address

4519 Woodruff Rd Ste 4
Columbus, GA 31904-6096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260527000456 AL Practitioner - Nurse Practitioner 5597235945 Reassigns benefits to 3 organizations
I20260609001617 IA Practitioner - Nurse Practitioner 5597235945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1776 Westlakes Pkwy
Suite 400
West Des Moines, IA 50266-8393

2005 Asbury Rd
Dubuque, IA 52001-3000

PO Box
Kansas City, MO 64184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-189727ALMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 4

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": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1912867789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 WOODRUFF RD STE 4",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 16TH AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011665",
            "telephone_number": "706-320-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "SHAWANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-189727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.