Sidney R Washington III, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

028667 Issued in GA

Practice address

1878 Brannen Lake Rd
Statesboro, GA 30458-7257

Phone

(912) 690-2724

Fax

(912) 852-2041

NPI assigned

Apr 11, 2006

Last updated

Jan 23, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1538122478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 BRANNEN LAKE RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304587257",
            "telephone_number": "912-690-2724",
            "fax_number": "912-852-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1878 BRANNEN LAKE RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304587257",
            "telephone_number": "912-690-2724",
            "fax_number": "912-852-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "SIDNEY",
        "middle_name": "R",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "028667",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "28667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326136A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Warren Marshall Ward, D.C.
• Shakayla Ware, LPC
• Marsha Foster Warren, LPC
• Katie Warrington
• John Lyndon Wasdin, D.M.D.
• David Watkins, RN
• Sebrina Madelyn Watkins, PA-C
• James Daniel Weathers, M.D.
• Trevor Weathersby, CRNA
• Chelsea Alexus Weaver, MED. LPC.

• Specialist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.