Organization Active NPI

Gaurang B Shah, MD, PSC

  • Specialist
  • Richmond, KY
National Provider Identifier
1003090457
Registry record updated Apr 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
32532 Issued in KY
Legal business name
GAURANG B SHAH, MD, PSC
Practice address
2025 Corporate Dr
Ste 1
Richmond, KY 40475-8884
Phone
(859) 625-0045
NPI assigned
Dec 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2011

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

Authorized official

Name
Gaurang B Shah, M.D.NPI 1922180694
Title
Owner
Phone
(859) 625-0045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 32532 KY Primary

Addresses

Primary practice location

2025 Corporate Dr
Ste 1
Richmond, KY 40475-8884

Mailing address

2025 Corporate Dr
Ste 1
Richmond, KY 40475-8884
Phone (859) 625-0045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000084 KY Part B Supplier - Clinic/Group Practice 1850285347 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0956264Gaurang Shah MD2025 Corporate Dr Suite #1, Richmond, KY 40475Provider-performed microscopyJan 22, 2027

National Provider Directory

National Provider Directory

Locations

2025 Corporate Dr
Ste 1
Richmond, KY 40475
Phone (859) 625-0045

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1003090457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 CORPORATE DR",
            "address_2": "STE 1",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758884",
            "telephone_number": "859-625-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 CORPORATE DR",
            "address_2": "STE 1",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758884",
            "telephone_number": "859-625-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAURANG B SHAH, MD, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "GAURANG",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-625-0045",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KY",
            "license": "32532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.