Bansi P Shah, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

17432 Issued in NC

Practice address

3318 Healy Dr
Winston Salem, NC 27103-1404

Phone

(336) 768-3530

Fax

(336) 768-1329

NPI assigned

May 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Piedmont Community Physicians PC

  • Phlebology Physician
  • Winston Salem, NC
  • NPI 1972915510
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286841600000",
    "number": "1033165261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3318 HEALY DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031404",
            "telephone_number": "336-768-3530",
            "fax_number": "336-768-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BANSI",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "17432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4098739",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975396",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "1022",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "147909",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA MEDICAID",
            "identifier": "73-0902-3",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "75396",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Shaffer, LCMHC-S
• Anna Shaffner, LPCA
• Deepal Pankaj Shah-Zamora, M.D.
• Anjay Prerak Shah
• Archana Manoj Shah, D.O
• Basil Shah, MD
• Hajra Zehra Shah, M.D.
• Jay Shah, R.PH
• Kevin Atul Shah
• Kinchit K Shah, M.D.

• Surgery Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; 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.