Individual provider Active NPI

La-Sho'Ndra Hagin

  • Family Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1568945764
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN139299 Issued in GA
Practice address
818 Saint Sebastian Way Ste 311
Augusta, GA 30901
Phone
(706) 724-3473
Fax
(706) 724-3493
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN139299 GA Primary

Addresses

Primary practice location

818 Saint Sebastian Way Ste 311
Augusta, GA 30901

Mailing address

PO Box 925
Augusta, GA 30903-0925
Phone (706) 774-7263

Other practice location 1

818 Saint Sebastian Way Ste 302
Augusta, GA 30901-2653
Phone (706) 724-3473

Other practice location 2

818 Saint Sebastian Way Ste 302
Augusta, GA 30901-2653
Phone (706) 724-3473

Other practice location 3

1348 Walton Way Ste 5100
Augusta, GA 30901-5108
Phone (706) 724-8611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN139299GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1568945764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309030925",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SAINT SEBASTIAN WAY STE 311",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "706-724-3473",
            "fax_number": "706-724-3493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "818 Saint Sebastian Way Ste 302",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012653",
            "country_code": "US",
            "telephone_number": "706-724-3473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "818 Saint Sebastian Way Ste 302",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309012653",
            "country_code": "US",
            "telephone_number": "706-724-3473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1348 Walton Way Ste 5100",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309015108",
            "country_code": "US",
            "telephone_number": "706-724-8611",
            "fax_number": "706-724-6202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGIN",
        "first_name": "LA-SHO'NDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN139299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.