SHANDA DEJOI NEWSOME (M.D.) – Family Medicine Physician, NPI 1760772313

SHANDA DEJOI NEWSOME (M.D.) is a healthcare provider. based in Leesburg, Georgia. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 73879 (GA). The NPI Number for SHANDA DEJOI NEWSOME (M.D.) is 1760772313

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
SHANDA DEJOI NEWSOME (M.D.)
NPI
1760772313
Phone
(229) 312-7490
Address
1390 US HIGHWAY 19 S
Enumeration Date
17 April 2011
Last Update Date
18 January 2022

Doctor Profile

Medical School Name
MOREHOUSE SCHOOL OF MEDICINE
Secondary Phone
4043647206
Graduation Year
2011 (15 years ago)
PAC ID
9436463940
Group Practice PAC ID
6204829013
Professional Enrollment ID
I20150728005479
Address ID
GA303051729AT3495XNEXX400

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:15State licenses:1Other namesUpdated within 12 months

3,102 FAMILY PRACTICE in GA

Provider Addresses for SHANDA DEJOI NEWSOME (M.D.)

  • 1390 US HIGHWAY 19 S

    LEESBURG, GA 317634831

    Phone: (229) 312-7490

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-07-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150728005479IFamily PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes3522$0
View full utilization report →

Insurance plans in this area (ZIP 31763)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204829013View full group profile

Reviews

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Frequently asked questions

How is SHANDA DEJOI NEWSOME (M.D.) identified in CMS data?
CMS-hosted NPPES data lists SHANDA DEJOI NEWSOME (M.D.) with NPI 1760772313.
Does the file indicate SHANDA DEJOI NEWSOME (M.D.) is practicing under active NPI?
Directory data currently reports SHANDA DEJOI NEWSOME (M.D.) as active.
What is SHANDA DEJOI NEWSOME (M.D.) best known for clinically?
Directory data describes SHANDA DEJOI NEWSOME (M.D.) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does SHANDA DEJOI NEWSOME (M.D.) list a practice location?
Patients near Leesburg, Georgia may find SHANDA DEJOI NEWSOME (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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