Cheryl A Basden, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

030951 Issued in GA

Practice address

3650 Steve Reynolds Blvd
Kaiser Permanente Gwinnett Comprehensive Medical Center
Duluth, GA 30096

Phone

(770) 931-6012

Fax

(678) 490-0349

NPI assigned

Mar 23, 2007

Last updated

Feb 6, 2022By 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

Other names 1

• Cheryl Williamson Basden Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Basden Family Practice, Inc.

  • Family Medicine Physician
  • Forest Park, GA
  • NPI 1245498567
  NPD Authorized official
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• The Doctor's Office, LLC

  • Family Medicine Physician
  • Stockbridge, GA
  • NPI 1578884516
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644105600000",
    "number": "1427175462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-504-5678",
            "fax_number": "678-490-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BLVD",
            "address_2": "KAISER PERMANENTE GWINNETT COMPREHENSIVE MEDICAL CENTER",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-931-6012",
            "fax_number": "678-490-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASDEN",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000485548J",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5440 Hillandale Dr",
            "city": "Lithonia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300584865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "WILLIAMSON BASDEN",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erjia Bao, MD
• Margaret Barnard, RBT
• Sara Barr, PA
• Kimberley Yatzary Barrera
• Madhuri P Basavaraju, M.D.
• Jennifer Michelle Bastecki, FNP-C
• Maria Batlle, MD
• Robert Erich Bauman, OD
• Be the Light Chiropractic (Be The Light Body and Spine)
• Betty Beal

• Family Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2022; 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.