DR. SHAUN A. CUMBERMACK (DNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1649062548

DR. SHAUN A. CUMBERMACK (DNP) is a healthcare provider. based in Augusta, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. APRN-NP240547 (GA). The NPI Number for DR. SHAUN A. CUMBERMACK (DNP) is 1649062548

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
DR. SHAUN A. CUMBERMACK (DNP)
NPI
1649062548
Phone
(706) 250-3902
Address
3665 WHEELER RD STE 1A
Enumeration Date
19 May 2025
Last Update Date
13 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7062503902
Graduation Year
2025 (1 year ago)
PAC ID
2860997004
Group Practice PAC ID
4789105172
Professional Enrollment ID
I20250926002575
Address ID
GA309096596AU3665XRDXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for DR. SHAUN A. CUMBERMACK (DNP)

  • 3665 WHEELER RD STE 1A

    AUGUSTA, GA 309096596

    Phone: (706) 250-3902

    Fax: (706) 303-4668

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-09-26

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
I20250926002575INurse 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 30909)

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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: 4789105172View full group profile
NameSpecialtyState
Marriage And Family TherapistGA
Mental Health CounselorGA
Nurse PractitionerGA
Mental Health CounselorGA
Nurse PractitionerGA
Mental Health CounselorFL
Mental Health CounselorGA

Reviews

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Frequently asked questions

How is DR. SHAUN A. CUMBERMACK (DNP) identified in CMS data?
CMS-hosted NPPES data lists DR. SHAUN A. CUMBERMACK (DNP) with NPI 1649062548.
Does the file indicate DR. SHAUN A. CUMBERMACK (DNP) is practicing under active NPI?
Directory data currently reports DR. SHAUN A. CUMBERMACK (DNP) as active.
What is DR. SHAUN A. CUMBERMACK (DNP)'s specialty?
The listing groups DR. SHAUN A. CUMBERMACK (DNP) with Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does DR. SHAUN A. CUMBERMACK (DNP) list a practice location?
Patients near Augusta, Georgia may find DR. SHAUN A. CUMBERMACK (DNP) in results; validate coverage separately.
Why does DR. SHAUN A. CUMBERMACK (DNP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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