Rudra Shah

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5017865 Issued in NC

Practice address

1046 E Wendover Ave
Greensboro, NC 27405-6712

Phone

(336) 272-1050

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCIICA/Endpoint/FCIICA
• Direct secure messaging: rshah638004@direct.ochin.org

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.

• Little Oaks Pediatrics, PLLC

  • Pediatrics Physician
  • Raleigh, NC
  • NPI 1073914024
  NPD (past)
• Rainbow Pediatrics of Fayetteville

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1356439566
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1053014118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 SOUTHPOINT TRL",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056712",
            "telephone_number": "336-272-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RUDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5017865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald T Shafer, MD
• Shae Lee Nicole Shaffer, NP
• Eric T. Shaffmaster, CRNA
• Christopher Tulip Shah, MD
• Jay A. Shah, DMD
• Chanel Shahnami
• Homa Shahnawaz, MD
• George Joseph Shalhoub, M.D.
• Shalom Pediatric Clinic
• Bernard Shalvey, LCMHC LCAS NCC

• Pediatric Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.