SHABAKA FLETCHER (NPI# 1780202960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780202960 |
| Entity Type | Individual |
| Full Name | SHABAKA FLETCHER |
| Practice Address |
901 Stoneview Trl Nw Lilburn GA 30047-7127 |
| Mailing Address |
Po Box 264 Lilburn GA 30048-0264 |
| Practice Telephone | 4043994374 |
| Mailing Telephone | 4043994974 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 372600000X | Adult Companion | Nursing Service Related Providers | ||
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers | ||
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers | ||
| N | 376J00000X | Homemaker | Nursing Service Related Providers |
| Street Address |
901 STONEVIEW TRL NW |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-7127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779481 | Karen Maria Jefferson | Technician | 1350 Ridenour Blvd Nw Apt 1303, Kennesaw, GA 30152-4588 | 2020-10-30 |
| 1114525193 | Bivens Nursing Services | Technician | 1123 Brown Ave, Columbus, GA 31906-2404 | 2020-10-13 |
| 1114539723 | Lisa Anita Riley | Technician | 3020 Bedrock Dr, Villa Rica, GA 30180-3422 | 2020-08-17 |
| 1770194458 | Michelle Perdue | Technician | 611 Trove Dr Nw, Rome, GA 30165-1065 | 2020-08-14 |
| 1972129914 | My Healing Angels LLC | Technician | 15 Mary Jane Ln, Covington, GA 30016-2325 | 2020-06-24 |
| 1053934802 | Simplicitys Personal Care Home LLC | Technician | 6741 Church St Ste 2, Riverdale, GA 30274-2249 | 2020-05-27 |
| 1811519622 | Torina L Collins | Technician | 103 Lavender St, Fort Valley, GA 31030-2625 | 2020-05-14 |
| 1225650658 | Melinda Frank | Technician | 2409 Mallard Ln # B, Hephzibah, GA 30815-5831 | 2020-05-07 |
| 1083248066 | Comfort Care Solutions Inc. | Technician | 2760 Broxton Mill Ct, Snellville, GA 30039-4437 | 2020-02-27 |
| 1942843792 | Ladonna Griffin | Technician | 813 Oakland Ave Sw, Rome, GA 30165-4125 | 2019-10-24 |
| 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.