DR. SHELLEY MACHUTA FERNANDES (NPI# 1639153828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639153828 |
| Entity Type | Individual |
| Full Name | DR. SHELLEY MACHUTA FERNANDES |
| Other Name | DR. SHELLEY MACHUTA |
| Credential | MD |
| Practice Address |
1100 Northside Forsyth Dr Ste 140 Cumming GA 30041-6012 |
| Practice Telephone | 7702927000 |
| Practice Fax Number | 7702927002 |
| Mailing Telephone | 7702927000 |
| Mailing Fax Number | 7702927002 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2017-02-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
044272 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000929585V | 05 | |
| GA | 000929585B | 05 | |
| GA | 457240757A | 05 | |
| GA | 000929585D | 05 |
| Street Address |
1100 NORTHSIDE FORSYTH DR STE 140 |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-6012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003814716 | John P Gorecki | Neurological Surgery | 1100 Northside Forsyth Dr, Suite 310, Cumming, GA 30041-6012 | 2005-07-07 |
| 1790221273 | James Quick | Pharmacist | 1100 Northside Forsyth Dr, Cumming, GA 30041-6012 | 2017-01-09 |
| 1417402108 | Kanitha K Sar | Nurse Practitioner | 1100 Northside Forsyth Dr, Suite 210, Cumming, GA 30041-6012 | 2016-08-23 |
| 1558712513 | Stephanie Upchurch | Specialist/Technologist, Other | 1100 Northside Forsyth Dr, 420, Cumming, GA 30041-6012 | 2016-06-30 |
| 1407205859 | Sydnie Christine Freeman | Audiologist | 1100 Northside Forsyth Dr, Ste 490, Cumming, GA 30041-6012 | 2016-06-07 |
| 1184070740 | Jacob Summerford | Physician Assistant | 1100 Northside Forsyth Dr, Suite 250, Cumming, GA 30041-6012 | 2016-05-12 |
| 1720459621 | Kellie Cain Henderson | Nurse Practitioner | 1100 Northside Forsyth Dr, Suite 330, Cumming, GA 30041-6012 | 2015-10-18 |
| 1194194548 | Neurosurgery Answer, LLC | Neurological Surgery | 1100 Northside Forsyth Dr, Suite 310, Cumming, GA 30041-6012 | 2015-09-16 |
| 1962806596 | Pretesh Parmar | Physician Assistant | 1100 Northside Forsyth Dr, Suite 340, Cumming, GA 30041-6012 | 2014-10-10 |
| 1205248382 | Tsz Yan Julitta Lam | Physical Therapist | 1100 Northside Forsyth Dr, Suite 340, Cumming, GA 30041-6012 | 2014-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730366865 | Edmund Lloyd Simon | Radiology | 1100 Northside Forsyth Dr, Ste 140, Cumming, GA 30041-6012 | 2008-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1962910679 | American Professional Associates LLC | Radiology | 33 Upper Riverdale Rd Sw Ste 105, Riverdale, GA 30274-2642 | 2018-01-16 |
| 1003324187 | American Professional Associates LLC | Radiology | 1136 Cleveland Ave Ste 119, East Point, GA 30344-3618 | 2018-01-11 |
| 1316387137 | Rakendu Prakash Shukla | Radiology | 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 30141-3768 | 2013-06-25 |
| 1023301082 | Jolinta Lin | Radiology | The Emory Clinic Dept of Radiation Oncology, 1365 Clifton Road, Ne, Atlanta, GA 30322-0001 | 2011-05-25 |
| 1679739825 | Charles Reginald Woods IIi | Radiology | 275 Professional Ct, Suite B, Riverdale, GA 30274-2531 | 2008-08-06 |
| 1003086216 | Coastal Radiation Oncology Assoc. | Radiology | 2500 Starling St Ste 107, Brunswick, GA 31520-4266 | 2008-03-04 |
| 1275710899 | Shannon Tucker Kahn | Radiology | 639 Kimberly Ln Ne, Atlanta, GA 30306-2224 | 2008-01-25 |
| 1295924801 | Brian Wise Weaver | Radiology | 1355 Heatherland Dr Sw, Atlanta, GA 30331-7460 | 2007-10-19 |
| 1225245798 | John W Devine, Md, PC | Radiology | 209 Pendleton Dr, Valdosta, GA 31602-1729 | 2007-05-16 |
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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.