Individual provider Active NPI

Shawanna L Watson

  • Basic Emergency Medical Technician
  • Douglasville, GA
National Provider Identifier
1740133172
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
A0130 Issued in GA
Practice address
517 Rocky Ridge Blvd
Douglasville, GA 30134-1526
Phone
(478) 874-5005
NPI assigned
Feb 16, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 146N00000X A0130 GA Primary

Addresses

Primary practice location

517 Rocky Ridge Blvd
Douglasville, GA 30134-1526

Mailing address

517 Rocky Ridge Blvd
Douglasville, GA 30134-1526
Phone (478) 874-5005

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A0130GAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ten10 Enterprises LLC Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1740133172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 ROCKY RIDGE BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341526",
            "telephone_number": "478-874-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 ROCKY RIDGE BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341526",
            "telephone_number": "478-874-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHAWANNA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medical Technician, Basic",
            "state": "GA",
            "license": "A0130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.