Individual provider Active NPI

Shavone Bellamy

  • Prosthetics Case Management
  • Orange Park, FL
National Provider Identifier
1982365979
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
108 Kingsley Ave Ste 210
Orange Park, FL 32073-5685
Phone
(912) 722-3281
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X
Prosthetics Case Management 1744P3200X GA Primary

Addresses

Primary practice location

108 Kingsley Ave Ste 210
Orange Park, FL 32073-5685

Mailing address

2164 US Highway 84
Blackshear, GA 31516-1160
Phone (254) 458-4138

Other practice location 1

1445 Woodmont Ln NW # 1205
Atlanta, GA 30318-2866
Phone (912) 288-5907

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 912-452-1130

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Monique LLC Current Accepting new patients

Locations

1445 Woodmont Ln NW
Atlanta, GA 30318
Phone (678) 921-9969

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1982365979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2164 US HIGHWAY 84",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161160",
            "telephone_number": "254-458-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 KINGSLEY AVE STE 210",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735685",
            "telephone_number": "912-722-3281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1445 Woodmont Ln NW # 1205",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303182866",
            "country_code": "US",
            "telephone_number": "912-288-5907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "SHAVONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "912-452-1130",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "address_1": "2164 US Highway 84",
            "city": "Blackshear",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315161160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.