SHONTIAYA S. PATTERSON FNP
NPI 1063762870
Nurse Practitioner - Family in Riverdale, GA

Q: What is Shontiaya Patterson's NPI number?

The NPI number for Shontiaya Patterson is 1063762870. It was assigned to this individual provider in the NPPES registry on September 19, 2012.

Q: What is Shontiaya Patterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since September 19, 2012PECOS Enrolled

1324 HIGHWAY 138 SW, RIVERDALE, GA 30296(770) 907-4949(770) 907-4022 Get Directions Write a Review

NPPES record last updated: December 3, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Shontiaya S. Patterson Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHONTIAYA S. PATTERSON FNP (NPI 1063762870) is an individual family provider in Riverdale, Georgia, licensed in Georgia (RN219785) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1063762870

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHONTIAYA S. PATTERSONCredential: FNP

Location Address1324 HIGHWAY 138 SWRiverdale, GA 30296-1404

Mailing Address141 Watkins Glen DrMcdonough, GA 30252-4061 · (770) 309-8302

Phone(770) 907-4949

Fax(770) 907-4022

Sole ProprietorNo

Enumeration DateSeptember 19, 2012

Last NPPES UpdateDecember 3, 2020

NPPES CertifiedDecember 3, 2020

✔ NPI 1063762870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN219785

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License RN219785 (GA)

1324 HIGHWAY 138 SW, Riverdale, GA 30296

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Secondary Practice Locations 2

Location 1175 Gwinnett DrLawrenceville, GA 30046-8444 · Phone (770) 339-2395 · Fax (678) 990-3997

Location 2559 Flat Shoals Ave SEAtlanta, GA 30316-2027 · Phone (770) 907-4949

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shontiaya S. Patterson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shontiaya Patterson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Love And Care

4.0 mi

Community/Behavioral Health

672 RIVER BEND DR
Jonesboro, GA 30238

Reassigned Medicare billing, Georgia enrollment

NPI 1760276331 (334) 398-5933

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30296 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAMILLE PLESHETTE COOK FNP-C

Nurse Practitioner (Family)