Shanon Renee Phillips, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN-NP169956 Issued in GA

Practice address

80 Parker Dr
Monroe, GA 30656-4747

Phone

(678) 381-2630

Fax

(678) 381-2627

NPI assigned

Feb 18, 2009

Last updated

Oct 13, 2025By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanon.phillips.1@28046.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grayson Pediatrics, LLC

  • Pediatrics Physician
  • Loganville, GA
  • NPI 1831500370
  NPD
• Grayson Pediatrics, LLC

  • Pediatrics Physician
  • Grayson, GA
  • NPI 1083026066
  NPD (past)
• Locust Grove Pediatrics

  • Pediatrics Physician
  • Locust Grove, GA
  • NPI 1174693519
  NPD (past)

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1932348745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PARKER DR",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306561100",
            "telephone_number": "783-812-6306",
            "fax_number": "678-381-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PARKER DR",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306564747",
            "telephone_number": "678-381-2630",
            "fax_number": "678-381-2627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "297 Cooper Rd",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300522518",
            "country_code": "US",
            "telephone_number": "678-381-2630",
            "fax_number": "678-381-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHANON",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP169956",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "APRN-NP169956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shanon.phillips.1@28046.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "Grayson Pediatrics, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "80 Parker Dr",
            "city": "Monroe",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306564747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Perrie, M.S., CCC-SLP
• Bheem Persaud, CCT, CSA
• Maleri Rose Pettit, CSFA
• Jessica Phillips
• Richard Lee Phillips, LCSW
• Piedmont Walton Hospital Inc
• Joaslanda Pierre, BSN, RN
• Misty Jovon Pinson, LCSW
• Sara Fitzpatrick Pittman, RPH, PHARMD
• Michelle Lynn Plaster, M.D.

• Pediatric Nurse Practitioner in Monroe, GA
• Providers in Monroe, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.