Individual provider Active NPI

Scheri-Lyn A. Makombe, MD

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1295022036
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME153100 Issued in FL
Practice address
1301 2ND Ave SW
Largo, FL 33770-2298
Phone
(727) 581-8767
Fax
(727) 581-3727
NPI assigned
Jun 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01072864A IN
Student in an Organized Health Care Education/Training Program 390200000X 11016301A IN
Family Medicine Physician 207Q00000X ME153100 FL Primary

Addresses

Primary practice location

1301 2ND Ave SW
Largo, FL 33770-2298

Mailing address

1301 2ND Ave SW
Largo, FL 33770-2298
Phone (727) 581-8767

Other identifiers 3

IdentifierTypeStateIssuer
P01424380OtherINRR MEDICARE
201068180MedicaidIN
K0M8MOtherFLFL BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190227002220 GA Practitioner - Family Practice 6204073836 Reassigns benefits to 2 organizations
I20220302002159 FL Practitioner - Family Practice 6204073836

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01072864AINMDFamily Medicine Physician
11016301AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgia Health Solutions PC CurrentSince Nov 13, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1100 Peachtree St NE
Ste 200
Atlanta, GA 30309
Phone (404) 445-5304

Interoperability endpoints

  • Direct secure messaging: scheri.makombe@rhsl-ga.direct.office.nextgen.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Adventhealth North PinellasTarpon Springs, FL, CCN 100055 Hospital Corporate Director Sep 18, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1295022036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702298",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702298",
            "telephone_number": "727-581-8767",
            "fax_number": "727-581-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOMBE",
        "first_name": "SCHERI-LYN",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01072864A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11016301A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME153100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01424380",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201068180",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "K0M8M",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.