Deshawn D Bellamy-Douglas

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

5562 Village Trce
Union City, GA 30291-5147

Phone

(786) 277-9720

NPI assigned

Jan 16, 2024

Last updated

Jan 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1992566111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 VILLAGE TRCE",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302915147",
            "telephone_number": "786-277-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5562 VILLAGE TRCE",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302915147",
            "telephone_number": "786-277-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY-DOUGLAS",
        "first_name": "DESHAWN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kesha Ballard
• Kenneth Baskett
• Michelle Bates
• Mary S Batson, REGISTERED NURSE
• Deborah Ann Bean, RN BSN
• Beatrice Berry
• Jaelyn Shantel Blackwell
• Dwight D Blake, MD
• Valencia L Blanks
• Tammara R Blunt, CNA

• Early Intervention Provider Agency in Union City, GA
• Providers in Union City, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.