Individual provider Active NPI

Shogofa Halimi, NP

  • Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1942079504
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN257906 Issued in GA
Practice address
115 Cherry St NE
Marietta, GA 30060-7205
Phone
(770) 793-5700
NPI assigned
Dec 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN257906 GA
Nurse Practitioner 363L00000X RN257906 GA Primary

Addresses

Primary practice location

115 Cherry St NE
Marietta, GA 30060-7205

Mailing address

115 Cherry St NE
Marietta, GA 30060-7205

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131002854 GA Practitioner - Nurse Practitioner 8426401977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
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)

12201 Hwy 92
Suite D
Woodstock, GA 30188-7141
Phone (770) 517-4621

1550 Kennesaw Due W Rd NW
Kennesaw, GA 30152-4338

1810 White Cir
Suite 105
Marietta, GA 30066-5836
Phone (678) 797-6820

2890 Delk Serd
Marietta, GA 30067-5326
Phone (770) 955-8620

3600 Sandy Plains Rd
Marietta, GA 30066-3020
Phone (770) 977-4547

4477 Towne Lake Pkwy
Suite 130
Woodstock, GA 30189-6720
Phone (770) 249-5620

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

5655 Atlanta Hwy
Alpharetta, GA 30004-5208
Phone (770) 691-0819

780 Church St NE
Marietta, GA 30060-7269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN257906GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2024 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

1810 White Cir
Ste 105
Marietta, GA 30066
Phone (678) 797-6820

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1703462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1942079504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CHERRY ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CHERRY ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607205",
            "telephone_number": "770-793-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALIMI",
        "first_name": "SHOGOFA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-25",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN257906",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN257906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.