Shandra Basil, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.014966 Issued in OH

Practice address

6905 Hospital Dr Ste 130
Dublin, OH 43016-9600

Phone

(614) 923-0300

Fax

(614) 923-0400

NPI assigned

Feb 14, 2018

Last updated

Sep 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shandra Kellough Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1932609179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "telephone_number": "419-529-2495",
            "fax_number": "614-544-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 HOSPITAL DR STE 130",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169600",
            "telephone_number": "614-923-0300",
            "fax_number": "614-923-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASIL",
        "first_name": "SHANDRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-14",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.014966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0447553",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANDRA",
            "last_name": "KELLOUGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donald E Bashaw
• Leah Bashaw, BA
• Stephanie Bashir
• Kaylee Bashline
• Basil Home Health LLC
• Jayita Basu Sarkar
• Mackenzie Bateman
• Shaifali Batra, MD
• Dale R Bauer, DDS
• Ashley Nicole Baugus, LSW

• Family Medicine Physician in Dublin, OH
• Providers in Dublin, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.