DR. SHANELLE A. CLARKE


Address: 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510
Phone: 4042562593

DR. SHANELLE A. CLARKE (NPI# 1104973999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104973999
Entity Type Individual
Full Name DR. SHANELLE A. CLARKE
Credential MD
Practice Address 2835 Brandywine Rd
Suite 300
Atlanta
GA 30341-5510
Practice Telephone 4042562593
Mailing Telephone 4042562593
Enumeration Date 2007-01-04
Last Update Date 2019-06-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0202X Pediatrics
Specialization: Pediatric Cardiology
74968 GA Allopathic & Osteopathic Physicians
N 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
50214 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 1104973999 05
WI 34768400 05
GA 003170465A 05

Office Location

Street Address 2835 BRANDYWINE RD
SUITE 300
City ATLANTA
State GA
Zip Code 30341-5510

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548262967 Chad Mao Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5540 2005-08-15
1851612261 Divya Suthar Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2010-06-21
1073756631 Holly Bauser-heaton Pediatrics 2835 Brandywine Rd, Suite 400, Atlanta, GA 30341 2009-04-13
1316111719 Michelle Wallace Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5540 2008-04-16
1164692174 Usama B Kanaan Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5540 2008-03-05
1972787760 Glen Joseph Iannucci Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2007-12-28
1568661767 Timotheus George Watson Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2007-07-17
1235336538 Fred Henry Rodriguez IIi Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2007-06-29
1538377502 Benjamin J Toole Emergency Medicine 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2007-05-21
1154539385 Brandon W Harden Emergency Medicine 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2007-05-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992207344 Rabun Marie Robertson Occupational Therapist 2320 Perimeter Park Drive, Atlanta, GA 30341 2018-03-01
1568986313 Charles Edge IIi Nurse Practitioner 4770 Buford Highway, Atlanta, GA 30341 2017-08-02
1366971277 Park Ridge Healthcare and Physical Medicine LLC Nurse Practitioner 2896 Chamblee Tucker Road, Suite 4, Atlanta, GA 30341 2017-06-06
1437502937 Chara Mcgill Counselor 13207 Jefferson Circle N, Chamblee, GA 30341 2016-07-20
1982063913 Stepping Stone of Atlanta Community/Behavioral Health 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 2016-02-18
1013317577 Marne Day Counselor 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341 2014-09-02
1013343680 Keelan Walker Speech-Language Pathologist 4961 Buford Highway Suite 201, Suite 201, Chamblee, GA 30341 2013-09-16
1578901955 Promonitor LLC Electrodiagnostic Medicine 3300 Northwest Expy Bldg 7, Atlanta, GA 30341 2013-06-07
1639415359 Lawanda B Cooke Health Educator 5280 Peachtree Ind Blvd, Chamblee, GA 30341 2012-12-28
1457602773 Arthur Macrae Wendel Family Medicine 4770 Buford Hwy Ms F60, Atlanta, GA 30341 2012-09-26
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Taxonomy Information

Taxonomy Code 2080P0202X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Cardiology

Taxonomy Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366491953 Derek A Fyfe Pediatrics 1405 Clifton Rd, Atlanta, GA 30322 2006-05-09
1548232036 Lazaros K Kochilas Pediatrics 2835 Brandywine Road, Suite 300, Atlanta, GA 30341-5540 2006-02-07
1487008330 Jay Patel Pediatrics 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 2016-04-18
1487099859 James A Nelson Jr. Pediatrics 1405 Clifton Rd Ne, Atlanta, GA 30322-4699 2013-04-30
1770846149 Michael Phillip Fundora Pediatrics 1405 Clifton Rd Ne, Atlanta, GA 30322 2012-06-20
1669762738 Zahidee Rodriguez Pediatrics 1405 Clifton Rd Ne, Atlanta, GA 30322-3039 2011-04-11
1487943544 Robert Dean Whitehill Pediatrics 5461 Meridian Marks Rd Ste 530, Atlanta, GA 30342-3283 2011-03-29
1851612261 Divya Suthar Pediatrics 2835 Brandywine Rd, Suite 300, Atlanta, GA 30341-5510 2010-06-21
1841516838 Yinn Khurn Ooi Pediatrics 1405 Clifton Rd Ne, Atlanta, GA 30322-1060 2010-04-15
1922269794 Pediatric Cardiology Services LLC Pediatrics 980 Johnson Ferry Rd Ne, Suite 560, Atlanta, GA 30342-1626 2008-06-24
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Competitor

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City ATLANTA
Zip Code 30341

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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