Feoderis N Basilio, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

050092 Issued in GA

Practice address

104 14TH St
Columbus, GA 31901-2131

Phone

(706) 507-5437

Fax

(706) 507-5499

NPI assigned

Feb 23, 2007

Last updated

Jun 30, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Feoderis Basilio Sebert Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: feoderis.basilio.1@14646.direct.athenahealth.com
• Direct secure messaging: feoderis.basilio@gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• I Basilio MD, PC

  • Pediatric Adolescent Medicine Physician
  • Columbus, GA
  • NPI 1356477616
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309392000000",
    "number": "1023143393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 14TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012131",
            "telephone_number": "706-507-5437",
            "fax_number": "706-507-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 14TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012131",
            "telephone_number": "706-507-5437",
            "fax_number": "706-507-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILIO",
        "first_name": "FEODERIS",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "050092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACH STATE HEALTH PLAN",
            "identifier": "000958702A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000958702A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GA",
            "identifier": "52009279",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "306085",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AL",
            "identifier": "60103339",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FEODERIS",
            "last_name": "SEBERT",
            "middle_name": "BASILIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Barron II, D.M.D.
• Shelby Williams Barron, PHARMD
• Derrick Bartlett, RBT
• Jabronica Thomas Bartlett
• Vanessa Barton
• Florida Selga Basilio, M.D.
• Traci Baskerville
• Arthur Bass
• Bernadette Bass
• Derek Russell Bass, DO

• Pediatric Adolescent Medicine Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Pediatric Adolescent Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.