SHAUNTILE ANDERSON (NP) – Nurse Practitioner, NPI 1316640238

SHAUNTILE ANDERSON (NP) is a healthcare provider. based in Waycross, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN270925 (GA). The NPI Number for SHAUNTILE ANDERSON (NP) is 1316640238

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
SHAUNTILE ANDERSON (NP)
NPI
1316640238
Phone
(912) 449-7100
Address
3455 Harris Rd
Enumeration Date
22 March 2023
Last Update Date
22 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9042222273
Graduation Year
2022 (4 years ago)
PAC ID
5294190716
Group Practice PAC ID
3274900410
Professional Enrollment ID
I20241210000087
Address ID
FL322168980JA263XXDRXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for SHAUNTILE ANDERSON (NP)

  • 3455 Harris Rd

    Waycross, GA 315038960

    Phone: (912) 449-7100

    Fax: (912) 449-7060

    Type: Location

  • 1007 MARY ST

    WAYCROSS, GA 315033823

    Phone: (912) 449-7111

    Fax: (912) 449-7060

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $168.

Total Amount is formed as General ($168) + Research ($0) + Ownership ($0) = $168.

Last reported payment date: 2024-08-07 • Largest payer in this snapshot: ABBVIE INC. ($55).

Total Amount

$168

General + Research + Ownership

Payments

9

Total payment records

General Amount

$168

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-07

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230504002657INurse PractitionerGATBD
I20241210000087INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274900410View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How do I look up SHAUNTILE ANDERSON (NP) by NPI?
Use NPI 1316640238 when you need to reference SHAUNTILE ANDERSON (NP) in forms, claims, or directories.
Is SHAUNTILE ANDERSON (NP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SHAUNTILE ANDERSON (NP)'s specialty in plain language?
Clinically, the directory lists SHAUNTILE ANDERSON (NP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for SHAUNTILE ANDERSON (NP)?
The page summarizes Waycross, Georgia for SHAUNTILE ANDERSON (NP); expand the address list for detail.
Is SHAUNTILE ANDERSON (NP) a real provider?
This page reflects official NPPES data for NPI 1316640238. Always confirm identity and privileges with the practice and licensing boards.

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