Healthcare Provider Details

I. General information

NPI: 1538712575
Provider Name (Legal Business Name): SHEKITA JAMES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEKITA REDDING

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 RUGBY AVE
COLLEGE PARK GA
30337-1835
US

IV. Provider business mailing address

1950 RUGBY AVE
COLLEGE PARK GA
30337-1835
US

V. Phone/Fax

Practice location:
  • Phone: 404-913-9130
  • Fax: 404-410-1278
Mailing address:
  • Phone: 404-913-9130
  • Fax: 404-410-1278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN223409
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberRN223409
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN223409
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberRN223409
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License NumberRN223409
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code207QB0505X
TaxonomyDiabetology (Internal Medicine) Physician
License NumberRN223409
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: