Individual provider Active NPI

Sherese Hullaby, NP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1992240428
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN151183 Issued in GA
Practice address
3896 Princeton Lakes Way
Atlanta, GA 30331
Phone
(404) 489-4444
NPI assigned
Dec 19, 2016
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN151183 GA Primary

Addresses

Primary practice location

3896 Princeton Lakes Way
Atlanta, GA 30331

Mailing address

5528 Mudlark Circle
Powder Springs, GA 30127
Phone (404) 456-6959

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
I20170104000821 GA Practitioner - Nurse Practitioner 4082995188 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grady Memorial Hospital CorporationGroup PAC ID 7517032998, shared by 7 NPIs, 365 clinicians

Practice addresses (Care Compare)

3896 Princeton Lakes Way SW
Atlanta, GA 30331-5510
Phone (404) 616-8880

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3050
Phone (404) 616-8880

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.48 of 100Reported as group
Quality
87.56
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Aug 1, 2022 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Oct 30, 2018 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Oct 30, 2018 Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

3896 Princeton Lakes Way SW
Atlanta, GA 30331
Phone (404) 489-4444

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#26019
Atlanta, GA 30303
Phone (404) 616-2219

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1482105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1992240428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 MUDLARK CIRCLE",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "30127",
            "telephone_number": "404-456-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 PRINCETON LAKES WAY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30331",
            "telephone_number": "404-489-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULLABY",
        "first_name": "SHERESE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-19",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN151183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.