Individual provider Active NPI

Shantelle Coe, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Johns Creek, GA
National Provider Identifier
1922683358
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-3573 Issued in HI
Practice address
5805 State Bridge Rd # G-112
Johns Creek, GA 30097-8220
Phone
(678) 369-5577
NPI assigned
Mar 17, 2021
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN-97583 HI
Registered Nurse 163W00000X RN186554 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-3573 HI Primary

Addresses

Primary practice location

5805 State Bridge Rd # G-112
Johns Creek, GA 30097-8220

Mailing address

5805 State Bridge Rd # G-112
Johns Creek, GA 30097-8220
Phone (678) 369-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN186554GAMDRegistered Nurse
RN-97583HIMDRegistered Nurse
APRN-3573HIMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1922683358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 STATE BRIDGE RD # G-112",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978220",
            "telephone_number": "678-369-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5805 STATE BRIDGE RD # G-112",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978220",
            "telephone_number": "678-369-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COE",
        "first_name": "SHANTELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "HI",
            "license": "RN-97583",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN186554",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "HI",
            "license": "APRN-3573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.