NPIMap

Organization Active NPI

I Basilio MD, PC

  • Pediatric Adolescent Medicine Physician
  • Columbus, GA
National Provider Identifier
1356477616
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
I BASILIO MD, PC
Practice address
2039 Warm Springs Rd
Columbus, GA 31904-7931
Phone
(706) 576-5570
NPI assigned
Feb 23, 2007
Last updated
Oct 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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

Authorized official

Name
Feoderis N Basilio, M.D.NPI 1023143393
Title
Physician
Phone
(706) 507-5437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

2039 Warm Springs Rd
Columbus, GA 31904-7931

Mailing address

104 14TH St
Columbus, GA 31901-2131
Phone (706) 507-5437

Other identifiers 1

IdentifierTypeStateIssuer
000958702CMedicaidGA

National Provider Directory

National Provider Directory

Locations

104 14th St
Columbus, GA 31901
Phone (706) 507-5437

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320019200000",
    "number": "1356477616",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 WARM SPRINGS RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047931",
            "telephone_number": "706-576-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I BASILIO MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-10-31",
        "status": "A",
        "authorized_official_last_name": "BASILIO",
        "authorized_official_first_name": "FEODERIS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-507-5437",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000958702C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.