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SHANE ALLAN WEATHERFORD
NPI 1780363762
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since July 17, 2023PECOS Enrolled
49 JESSE HILL JR DR SE STE 102, ATLANTA, GA 30303(404) 778-1372 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Shane Allan Weatherford NPPES

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

SHANE ALLAN WEATHERFORD (NPI 1780363762) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780363762
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHANE ALLAN WEATHERFORD
Location Address49 JESSE HILL JR DR SE STE 102Atlanta, GA 30303-3049
Mailing Address49 Jesse Hill Jr Dr Se Ste 102Atlanta, GA 30303-3049 · (404) 778-1372
Phone(404) 778-1372
Sole ProprietorNo
Enumeration DateJuly 17, 2023
NPPES CertifiedJuly 17, 2023
✔ NPI 1780363762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
49 JESSE HILL JR DR SE STE 102, Atlanta, GA 30303
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane Allan Weatherford 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.

Other Providers at the Same Location NPPES 2

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

CINDY XINDI WANG
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE STE 102
ATLANTA, GA 30303
Fulton County (404) 778-1372
TEJAS JOSHI
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE STE 102
ATLANTA, GA 30303
Fulton County (404) 778-1372

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Weatherford's NPI number?

The NPI number for Shane Weatherford is 1780363762. It was assigned to this individual provider in the NPPES registry on July 17, 2023.

Where is Shane Weatherford located?

Shane Weatherford practices at 49 Jesse Hill Jr Dr SE Ste 102, Atlanta, GA 30303. The listed phone number is (404) 778-1372.

What is Shane Weatherford's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Shane Weatherford enrolled in Medicare?

Yes. Shane Weatherford is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shane Weatherford was last updated on July 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.