Shaleisa Sade' Echols, CMA

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

Y7A4Z2J6 Issued in GA

Practice address

603 Maplewood LN
Hull, GA 30646-4015

Phone

(706) 621-9568

NPI assigned

Jan 26, 2021

Last updated

Jan 26, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Medical Assistant

State licenses

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1215527957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 MAPLEWOOD LN",
            "city": "HULL",
            "state": "GA",
            "postal_code": "306464015",
            "telephone_number": "706-621-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MAPLEWOOD LN",
            "city": "HULL",
            "state": "GA",
            "postal_code": "306464015",
            "telephone_number": "706-621-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHOLS",
        "first_name": "SHALEISA",
        "middle_name": "SADE'",
        "credential": "CMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "GA",
            "license": "Y7A4Z2J6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Hull, GA
• Providers in Hull, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.