Shonta K Winbush, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3776 Issued in GA

Practice address

704 Gil Harbin Ind Blvd
Valdosta, GA 31602

Phone

(229) 242-9003

Fax

(229) 242-0490

NPI assigned

Sep 26, 2006

Last updated

Jul 8, 2007By 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 1

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: swinbush539992@selfregional.direct-ci.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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment Care Compare group
• Anmed Urgent Care LLC

  dba AnMed Urgent Care

  • Urgent Care Clinic/Center
  • Anderson, SC
  • NPI 1467289637
  Medicare reassignment
• Emergency Medicine South LLC

  • Emergency Medicine Physician
  • Valdosta, GA
  • NPI 1194785170
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093816662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "31643",
            "telephone_number": "229-263-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 GIL HARBIN IND BLVD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-242-9003",
            "fax_number": "229-242-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINBUSH",
        "first_name": "SHONTA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "3776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244832811A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Claire Wills, M.ED, CF-SLP
• Amanda Jo Wilson, RBT
• Caitlyn Elizabeth Wilson, OTR/L
• Nyle Kunyri Wilson, DDS
• Steven Michael Wilson, O.D.
• Jessica Wing
• Winnersville Long Term Care Packaging (AmeriMed Long-Term Care Packaging)
• Winnersville Pharmacy LLC (Amerimed Long-Term Care Packaging)
• Winnersville Pharmacy, LLC (Amerimed Pharmacy)
• July Wise

• Physician Assistant in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.