Individual provider Active NPI

Stephen T Bashuk, M.D.

  • Obstetrics Physician
  • Cumming, GA
National Provider Identifier
1952338428
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
46040 Issued in GA
Practice address
1505 Northside Blvd
Suite 3500
Cumming, GA 30041-7623
Phone
(770) 886-3555
Fax
(770) 205-6501
NPI assigned
Jun 28, 2006
Last updated
Mar 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 46040 GA Primary

Addresses

Primary practice location

1505 Northside Blvd
Suite 3500
Cumming, GA 30041-7623

Mailing address

1505 Northside Blvd
Suite 3500
Cumming, GA 30041-7623
Phone (770) 886-3555

Other identifiers 1

IdentifierTypeStateIssuer
000909565JMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20160705000060 AR Practitioner - Obstetrics/Gynecology 7618943697 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46040GAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Parkhill PA CurrentSince Jun 22, 2016 Accepting new patients
Obhg Arkansas West PA Current Accepting new patients
Obhg Arkansas West PA CurrentSince May 18, 2019 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Dec 23, 2021 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Dec 23, 2021 Accepting new patients
Obhg Arkansas, PA CurrentSince Jun 10, 2016 Accepting new patients
Northside Primary Care Professional Services, LLC PastSince Jan 15, 2023 Accepting new patients
North Pointe OB GYN Associates LLC Past Accepting new patients
Alliance OB GYN PC Past Accepting new patients
North Pointe OB GYN Associates, LLC Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

3215 N Northhills Blvd
Ste 3
Fayetteville, AR 72703
Phone (479) 521-4444

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

7001 Rogers Ave
Ste 403
Fort Smith, AR 72903
Phone (479) 573-3101

7001 Rogers Ave
Ste 502
Fort Smith, AR 72903
Phone (479) 484-5901

7301 Rogers Ave
Fort Smith, AR 72903
Phone (479) 314-4600

Organizations & group practices 11

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1952338428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "SUITE 3500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "770-886-3555",
            "fax_number": "770-205-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD",
            "address_2": "SUITE 3500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417623",
            "telephone_number": "770-886-3555",
            "fax_number": "770-205-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHUK",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "GA",
            "license": "46040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000909565J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.