Individual provider Active NPI

Sebrina Madelyn Watkins, PA-C

  • Physician Assistant
  • Statesboro, GA
National Provider Identifier
1457730574
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6621 Issued in GA
Practice address
1096 Bermuda Run
Statesboro, GA 30458-0858
Phone
(912) 871-5150
NPI assigned
May 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6621 GA Primary
Physician Assistant 363A00000X MA065094 PA

Addresses

Primary practice location

1096 Bermuda Run
Statesboro, GA 30458-0858

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405

Other practice location 1

1401 Roosevelt Ave
York, PA 17404-2244
Phone (717) 356-5198

Other practice location 2

118 E Broad St
Mount Vernon, GA 30445-3018
Phone (912) 583-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150806010471 GA Practitioner - Physician Assistant 7911211727 Reassigns benefits to 1 organization
I20231114001698 PA Practitioner - Physician Assistant 7911211727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Saint Josephs Candler Dr
Suite 100
Pooler, GA 31322-9587
Phone (912) 737-2250

1096 Bermuda Run
Statesboro, GA 30458-0858
Phone (912) 871-5150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6621GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Dec 11, 2023 Accepting new patients
Wellspan Medical Group CurrentSince Dec 11, 2023 Accepting new patients
St Josephs Candler Urgent Care Centers LLC CurrentSince Feb 11, 2025 Accepting new patients

Locations

64 Oracal Pkwy
Bldg 1
Ellabell, GA 31308
Phone (912) 214-7920

780 E Oglethorpe Hwy
Hinesville, GA 31313
Phone (912) 332-7262

101 Saint Josephs Candler Dr
Ste 100
Pooler, GA 31322
Phone (912) 450-1945

107 Canal St
Pooler, GA 31322
Phone (912) 450-1945

13314 Highway 144
Ste C
Richmond Hill, GA 31324
Phone (912) 910-2010

5621 Highway 21 S
Rincon, GA 31326
Phone (912) 295-5860

361 Commercial Dr
Savannah, GA 31406
Phone (912) 355-6221

1096 Bermuda Run
Statesboro, GA 30458
Phone (912) 871-5150

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

2775 N George St
York, PA 17406
Phone (717) 812-7300

1401 Roosevelt Ave
York, PA 17404
Phone (717) 356-6250

Interoperability endpoints

  • Direct secure messaging: swatkins416030@wellspan.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1457730574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405",
            "fax_number": "912-583-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 BERMUDA RUN",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580858",
            "telephone_number": "912-871-5150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174042244",
            "country_code": "US",
            "telephone_number": "717-356-5198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "GA",
            "postal_code": "304453018",
            "country_code": "US",
            "telephone_number": "912-583-2277",
            "fax_number": "912-583-2286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "SEBRINA",
        "middle_name": "MADELYN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6621",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.