Individual provider Active NPI

Shan R George, N.P.

  • Family Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1962741967
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
242765 Issued in GA
Practice address
6801 Airport Blvd
Mobile, AL 36608-3709
Phone
(904) 372-3943
Fax
(904) 212-1618
NPI assigned
Feb 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3-000797 AL
Family Nurse Practitioner 363LF0000X 242765 GA Primary

Addresses

Primary practice location

6801 Airport Blvd
Mobile, AL 36608-3709

Mailing address

7751 Belfort Pkwy Ste 120
Jacksonville, FL 32256-6921
Phone (904) 372-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20230426000527 AL Practitioner - Nurse Practitioner 5395100358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.91 of 100Reported as group
Quality
90.02
Improvement activities
40
Cost
76.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242765GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes Management Partners LLC CurrentSince Apr 24, 2023 Accepting new patients
Diabetes Management Partners LLC CurrentSince Apr 24, 2023 Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

50 Medical Park Dr E
Birmingham, AL 35235
Phone (205) 838-3000

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

7751 Belfort Pkwy
Ste 120
Jacksonville, FL 32256

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": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1962741967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 BELFORT PKWY STE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566921",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083709",
            "telephone_number": "904-372-3943",
            "fax_number": "904-212-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "SHAN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "3-000797",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "242765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.