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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ZACHARY THOMAS SELF MD
NPI 1104628635
Student in an Organized Health Care Education/Training Program in Augusta, GA

Active since March 25, 2025
1120 15TH ST, AUGUSTA, GA 30912(706) 721-4451 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Zachary Thomas Self Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ZACHARY THOMAS SELF MD (NPI 1104628635) is an individual student in an organized health care education/training program in Augusta, Georgia, licensed in Georgia (113889) and active in the NPI registry since March 2025.

NPPES Registry Identity

NPI1104628635
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameZACHARY THOMAS SELFCredential: MD
Location Address1120 15TH STAugusta, GA 30912-0004
Mailing Address1120 15th StAugusta, GA 30912-0004 · (706) 721-4451
Phone(706) 721-4451
Sole ProprietorNo
Enumeration DateMarch 25, 2025
Last NPPES UpdateJune 18, 2026
NPPES CertifiedJune 18, 2026
✔ NPI 1104628635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in GA · 113889
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1120 15TH ST, Augusta, GA 30912
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TOYA HESTER KELLEY MD
Family Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-3157
DR. JACK BRADLEY ELLIS D.O.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
MR. ROBERT SCOTT SMITH FNP-C
Nurse Practitioner (Family)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8549
SAMI MOHAMMED ALSHEHRY
Student in an Organized Health Care Education/Training Program
1120 15TH ST, 1065
AUGUSTA, GA 30912
Richmond County (706) 721-2411
LUIS ALBERTO VELASQUEZ ZARATE M.D
Pathology (Anatomic Pathology & Clinical Pathology)
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-2771
DR. BRYAN RICHARD BROACH M.D.
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
JANELLE MCGILL M.D.
Pediatrics
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623
DR. KAYLA ASHLEY SHAHBAZIAN DO
Internal Medicine
1120 15TH ST
AUGUSTA, GA 30912
Richmond County (706) 721-8623

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Zachary Self's NPI number?

The NPI number for Zachary Self is 1104628635. It was assigned to this individual provider in the NPPES registry on March 25, 2025.

Where is Zachary Self located?

Zachary Self practices at 1120 15th St, Augusta, GA 30912. The listed phone number is (706) 721-4451.

What is Zachary Self's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Zachary Self was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.