Individual provider Active NPI

Edmond Shih, M.D.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1023451408
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
076180 Issued in GA
Practice address
5461 Buford Hwy NE
Atlanta, GA 30340-1124
Phone
(770) 457-5556
Fax
(770) 457-7776
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 076180 GA Primary

Addresses

Primary practice location

5461 Buford Hwy NE
Atlanta, GA 30340-1124

Mailing address

5461 Buford Hwy NE
Atlanta, GA 30340-1124
Phone (770) 457-5556

Other identifiers 1

IdentifierTypeStateIssuer
003179826AMedicaidGA

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
076180GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prompt Medical Care Past Accepting new patients

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1023451408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 BUFORD HWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303401124",
            "telephone_number": "770-457-5556",
            "fax_number": "770-457-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 BUFORD HWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303401124",
            "telephone_number": "770-457-5556",
            "fax_number": "770-457-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIH",
        "first_name": "EDMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "076180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003179826A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.