SHALLOWFORD WELLNESS CENTER LLC – Community/Behavioral Health Agency, NPI 1235917469

SHALLOWFORD WELLNESS CENTER LLC is a healthcare provider. based in Atlanta, Georgia. specializing in Community/Behavioral Health Agency. The NPI Number for SHALLOWFORD WELLNESS CENTER LLC is 1235917469

Main info

Organization
Name
SHALLOWFORD WELLNESS CENTER LLC
NPI
1235917469
Phone
Not provided
Address
2521 OAK GROVE ESTS NE
Authorized Official
SOFIA KHAN CEO
Enumeration Date
19 September 2023
Last Update Date
4 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience29
Completeness85
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for SHALLOWFORD WELLNESS CENTER LLC

  • 2521 OAK GROVE ESTS NE

    ATLANTA, GA 303457601

    Phone:

    Type: Mailing

  • 3300 NORTHEAST EXPY NE

    ATLANTA, GA 303413932

    Phone: (404) 435-6604

    Type: Location

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: 2024-04-30

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
O20240404004049OCommunity Mental Health CenterGATBD
O20240430001392OClinic/Group PracticeGATBD

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 30345)

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Reviews

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Frequently asked questions

What is the standard ID for SHALLOWFORD WELLNESS CENTER LLC in the U.S.?
In the U.S., SHALLOWFORD WELLNESS CENTER LLC is identified by NPI 1235917469.
Does the public listing show SHALLOWFORD WELLNESS CENTER LLC as active?
SHALLOWFORD WELLNESS CENTER LLC's NPI record reflects an active status in NPPES.
How should patients interpret SHALLOWFORD WELLNESS CENTER LLC's specialty?
The extract shows Community/Behavioral Health Agency for SHALLOWFORD WELLNESS CENTER LLC. Clinical services aligned with this taxonomy classification.
Which community is linked to SHALLOWFORD WELLNESS CENTER LLC?
SHALLOWFORD WELLNESS CENTER LLC shows a connection to Atlanta, Georgia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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