MS. NAIOMI MICHELLE SHOCKLEY (NPI# 1457486425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457486425 |
| Entity Type | Individual |
| Full Name | MS. NAIOMI MICHELLE SHOCKLEY |
| Credential | CPNP |
| Practice Address |
1115 Mount Zion Rd Ste E Morrow GA 30260-2266 |
| Mailing Address |
1115 Mount Zion Rd Suite E Morrow GA 30260-2266 |
| Practice Telephone | 7709609999 |
| Practice Fax Number | 7709600931 |
| Mailing Telephone | 7709609999 |
| Mailing Fax Number | 7709600931 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2015-05-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN159492 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003134388B | 05 | |
| GA | TAX ID | 472261189 | 01 |
| GA | LICENSE # | RN159492 | 01 |
| GA | NATIONAL BD OF PED NURSE | NCO000006 | 01 |
| GA | PEDS NURSING CERTIFICATIO | 20060526 | 01 |
| GA | TAX ID # | 581238651 | 01 |
| Street Address |
1115 MOUNT ZION RD STE E |
| City | MORROW |
| State | GA |
| Zip Code | 30260-2266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821496241 | Healthy Stages Pediatrics | Nurse Practitioner | 1115 Mount Zion Rd, Suite E, Morrow, GA 30260-2266 | 2014-12-17 |
| 1619169968 | Michele Lee Wiegmann-ross | Nurse Practitioner | 1115 Mount Zion Rd, Suite E, Morrow, GA 30260-2266 | 2007-08-10 |
| 1255468484 | Jeanne I Fell | Nurse Practitioner | 2201 Mount Zion Pkwy, Morrow, GA 30260-3312 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565811 | Rebecca Danielle Wegman | Nurse Practitioner | 5445 Meridian Mark Rd Ste 380, Atlanta, GA 30342-4755 | 2020-10-09 |
| 1629675657 | Casey Cullins | Nurse Practitioner | 980 Johnson Fy Rd Ne Ste 680, Atlanta, GA 30342-1608 | 2020-10-02 |
| 1336755289 | Taylor Bishop | Nurse Practitioner | 51 Hidden Lake Ct, Savannah, GA 31419-1664 | 2020-09-16 |
| 1942815717 | Valerie Renee' Grenald | Nurse Practitioner | Augusta University Health, Augusta, GA 30912-0001 | 2020-09-09 |
| 1538798095 | Brittany Nicole Heitkamp | Nurse Practitioner | 5461 Meridian Mark Rd Ste 540, Atlanta, GA 30342-3283 | 2020-04-06 |
| 1629606421 | Anna Elizabeth Patton | Nurse Practitioner | 12 Sammy Mcghee Blvd Ste 102, Jasper, GA 30143-7712 | 2020-03-29 |
| 1093342131 | Lindsay Pare | Nurse Practitioner | 2225 Twin Lakes Dr, Atlanta, GA 30339-4123 | 2020-03-26 |
| 1215564976 | Stephanie Laurel Toole | Nurse Practitioner | 625 Big Shanty Rd Nw, Kennesaw, GA 30144-3646 | 2020-03-24 |
| 1740816487 | Aleksa Rozman | Nurse Practitioner | 1121 Johnson Ferry Rd Ste 220, Marietta, GA 30068-2763 | 2020-03-13 |
| 1912530866 | Rebecca L Brigola | Nurse Practitioner | 4120 Five Forks Trickum Rd Sw Ste 102, Lilburn, GA 30047-8975 | 2020-02-19 |
| Find all providers with the same taxonomy | ||||
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| 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.