Individual provider Active NPI

Shannon Nicole Mitchell, NP

  • Primary Care Nurse Practitioner
  • Macon, GA
National Provider Identifier
1942943667
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN271894 Issued in GA
Practice address
654 1St St Ste 330
Macon, GA 31201-2851
Phone
(478) 738-9443
NPI assigned
Apr 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN271894 GA Primary

Addresses

Primary practice location

654 1St St Ste 330
Macon, GA 31201-2851

Mailing address

180 RL Wheeler Rd
Macon, GA 31211-6700
Phone (804) 712-3853

Other practice location 1

100 Tommy Stalnaker Dr Ste 100A
Warner Robins, GA 31088-1402
Phone (855) 228-4597

Other practice location 2

5400 Riverside Dr Ste 202
Macon, GA 31210-0818
Phone (478) 787-0059

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
I20221130000555 GA Practitioner - Nurse Practitioner 4981072618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Heart Physicians LLCGroup PAC ID 0345204418, 8 clinicians

Practice addresses (Care Compare)

654 1St St
Macon, GA 31201-2851
Phone (478) 738-9443

Hospital & facility affiliations

  • Atrium Health Navicent the Medical Center Hospital, Macon, GA, CCN 110107
  • Coliseum Medical Centers, LLC, Dba Hospital, Macon, GA, CCN 110164
  • Piedmont Macon North Hospital Hospital, Macon, GA, CCN 110201

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN271894GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Heart Physicians LLC CurrentSince Apr 2, 2025 Accepting new patients
Ga Diagnostic Providers LLC CurrentSince Oct 1, 2022 Accepting new patients
Avilys-Sleep & Eeg CurrentSince Oct 3, 2022 Accepting new patients
Macon Electrophysiology Associates Past Accepting new patients

Locations

105 Avera Dr
Fort Valley, GA 31030
Phone (478) 633-1458

5400 Riverside Dr
Ste 202
Macon, GA 31210
Phone (478) 787-0059

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

5400 Riverside Dr
Ste 101
Macon, GA 31210

654 1st St
Ste 330
Macon, GA 31201
Phone (478) 738-9443

654 1st St
Macon, GA 31201
Phone (478) 738-9443

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

800 1st St
Ste 330
Macon, GA 31201
Phone (912) 738-9443

2300 Northside Xing
#B
Macon, GA 31210
Phone (855) 228-4597

540 W Thomas St
Ste E
Milledgeville, GA 31061
Phone (478) 738-9443

100 Tommy Stalnaker Dr
Ste 100A
Warner Robins, GA 31088
Phone (478) 787-0059

1710 Watson Blvd
Warner Robins, GA 31093
Phone (478) 394-6061

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HHAAAA
  • Direct secure messaging: smitchell3008524@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1942943667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 RL WHEELER RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312116700",
            "telephone_number": "804-712-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 1ST ST STE 330",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012851",
            "telephone_number": "478-738-9443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Tommy Stalnaker Dr Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310881402",
            "country_code": "US",
            "telephone_number": "855-228-4597",
            "fax_number": "855-428-4597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5400 Riverside Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312100818",
            "country_code": "US",
            "telephone_number": "478-787-0059",
            "fax_number": "855-428-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN271894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.