SHUCONDA STURDIVANT (NP-C) – Family Nurse Practitioner, NPI 1528340056

SHUCONDA STURDIVANT (NP-C) is a healthcare provider. based in Bogart, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN194195 (GA). The NPI Number for SHUCONDA STURDIVANT (NP-C) is 1528340056

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
SHUCONDA STURDIVANT (NP-C)
NPI
1528340056
Phone
Not provided
Address
248 BOB WAGES RD
Enumeration Date
11 September 2011
Last Update Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7707867053
Graduation Year
2011 (15 years ago)
PAC ID
2062670342
Group Practice PAC ID
1951299163
Professional Enrollment ID
I20120215000588
Address ID
GA300142566CO5126XNEXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:14State licenses:2Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for SHUCONDA STURDIVANT (NP-C)

  • 248 BOB WAGES RD

    BOGART, GA 306222996

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 117 Open Payments records for all available years, with a total value of $2,580.

Total Amount is formed as General ($2,580) + Research ($0) + Ownership ($0) = $2,580.

Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Alkermes, Inc. ($512).

Total Amount

$2,580

General + Research + Ownership

Payments

117

Total payment records

General Amount

$2,580

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-13

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2012-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20120215000588INurse PractitionerGATBD

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 30622)

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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: 1951299163View full group profile
NameSpecialtyState
Physician AssistantGA
Nurse PractitionerGA
Internal MedicineGA
H O S P I T A L I S TGA
Internal MedicineGA
Internal MedicineGA
Hospitalist, Internal MedicineIN
N E U R O L O G YGA
Nurse PractitionerGA
Hospitalist, Internal MedicineGA

Reviews

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Frequently asked questions

What NPI should I save for SHUCONDA STURDIVANT (NP-C)?
Save NPI 1528340056 if you need a stable reference for SHUCONDA STURDIVANT (NP-C).
Is SHUCONDA STURDIVANT (NP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does SHUCONDA STURDIVANT (NP-C) work in?
You can think of SHUCONDA STURDIVANT (NP-C) as practicing within Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for SHUCONDA STURDIVANT (NP-C)?
The page summarizes Bogart, Georgia for SHUCONDA STURDIVANT (NP-C); expand the address list for detail.
How can I contact SHUCONDA STURDIVANT (NP-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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