Shekella Blanden, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN223070 Issued in GA

Practice address

174 Tallassee TRL
Leesburg, GA 31763-3770

Phone

(904) 716-3749

NPI assigned

Mar 7, 2017

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

Enrolled in GA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pruitthealth Physicians Services, LLC

  • Internal Medicine Physician
  • Norcross, GA
  • NPI 1043676299
  Medicare reassignment NPD

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1396285516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 TALLASSEE TRL",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317633770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 TALLASSEE TRL",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317633770",
            "telephone_number": "904-716-3749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDEN",
        "first_name": "SHEKELLA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN223070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orlandria Michelle Bennett-Reed
• Elisabeth Bennett, CTRS
• Robert L Bennett III
• Trebla Cole Bennett, LPC
• Bewell Integrative Health
• Board of County Commissioners in Lee County Georgia
• Serra Boone
• Jason B Boyd, NP
• Ashley Brinkley, COTA/L
• Anna Louise Britt, OD

• Primary Care Nurse Practitioner in Leesburg, GA
• Providers in Leesburg, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.