MEDICARE: KENYA SHATRESE GROOMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1700732120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENYA SHATRESE GROOMS

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 OLD DAWSON RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-1599
Country	:	US
Telephone Number	:	855-832-6727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

Similar Medicare Providers

1598877235 — TRACEY HOWELL RPH
Practice Location Address:

2800 OLD DAWSON RD
ALBANY, GA
31707-1599

Practice Phone: 229-888-5039
Practice Fax:

1417049461 — JOHNNY KENNETH CREEL
Practice Location Address:

2800 OLD DAWSON RD
ALBANY, GA
31707-1599

Practice Phone: 229-888-3530
Practice Fax:

1134213952 — MRS. AMANDA H DEAN PHARMD
Practice Location Address:

2800 OLD DAWSON RD
ALBANY, GA
31707-1599

Practice Phone: 229-888-3530
Practice Fax: 229-888-5039

1508647090 — DWAN Y ASHE LMT NMT MLD-C
Practice Location Address:

1122 W BROAD AVE
ALBANY, GA
31707-4340

Practice Phone: 678-408-1191
Practice Fax:

1932055910 — MEGAN STROUD
Practice Location Address:

2701 MEREDYTH DR
ALBANY, GA
31707-2267

Practice Phone: 229-376-0524
Practice Fax:

1952471070 — MR. JOHN P RODMAN SR. CPO
Practice Location Address:

2925 LEDO RD STE 25
ALBANY, GA
31707-1277

Practice Phone: 229-430-9778
Practice Fax: 229-430-1347

Directions to “ KENYA SHATRESE GROOMS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.