Individual provider Active NPI

Sharon Lebedin, CPNP

  • Pediatric Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1821264516
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN055732NP Issued in GA
Practice address
1121 Johnson Ferry Rd
Suite 220
Marietta, GA 30068-5425
Phone
(770) 977-0094
Fax
(770) 509-5177
NPI assigned
May 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN055732NP GA Primary

Addresses

Primary practice location

1121 Johnson Ferry Rd
Suite 220
Marietta, GA 30068-5425

Mailing address

1121 Johnson Ferry Rd
Suite 220
Marietta, GA 30068-5425
Phone (770) 977-0094

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN055732NPGAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Cobb Pediatrics and Adolescent Medicine, PC Past 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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1821264516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD",
            "address_2": "SUITE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685425",
            "telephone_number": "770-977-0094",
            "fax_number": "770-509-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD",
            "address_2": "SUITE 220",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685425",
            "telephone_number": "770-977-0094",
            "fax_number": "770-509-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEDIN",
        "first_name": "SHARON",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN055732NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; 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.