Individual provider Active NPI

Sharonda Lasha Basby, FNP-C

  • Family Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1669875225
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN207536 Issued in GA
Practice address
2054 Watson Blvd
Warner Robins, GA 31093-3634
Phone
(478) 231-9223
Fax
(478) 918-0771
NPI assigned
Sep 26, 2014
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 207536 GA
Family Nurse Practitioner 363LF0000X RN207536 GA Primary

Addresses

Primary practice location

2054 Watson Blvd
Warner Robins, GA 31093-3634

Mailing address

408 Angelina Grace Dr
Warner Robins, GA 31088-3295
Phone (478) 231-9223

Other practice location 1

1531 Watson Blvd
Warner Robins, GA 31093-3449
Phone (478) 599-0110

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170117001545 GA Practitioner - Nurse Practitioner 2567766090 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207536GAMDFamily Nurse Practitioner
RN207536GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Jul 8, 2024 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

1531 Watson Blvd
Warner Robins, GA 31093
Phone (478) 599-0110

2054 Watson Blvd
Warner Robins, GA 31093
Phone (478) 918-0770

707 N Houston Rd
Warner Robins, GA 31093
Phone (478) 328-9901

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1669875225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 ANGELINA GRACE DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883295",
            "telephone_number": "478-231-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933634",
            "telephone_number": "478-231-9223",
            "fax_number": "478-918-0771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1531 Watson Blvd",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310933449",
            "country_code": "US",
            "telephone_number": "478-599-0110",
            "fax_number": "478-599-0001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASBY",
        "first_name": "SHARONDA",
        "middle_name": "LASHA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "207536",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN207536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.