NPIMap

Organization Active NPI

Vikram R. Shukla, MD Child, Adolescent & Adult Psychiatry Services

  • Psychiatry Physician
  • Gastonia, NC
National Provider Identifier
1053775189
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
33304 Issued in NC
Legal business name
VIKRAM R. SHUKLA, MD CHILD, ADOLESCENT & ADULT PSYCHIATRY SERVICES
Practice address
839 Majestic CT
Suite 8
Gastonia, NC 28054-5147
Phone
(704) 868-8988
Fax
(704) 868-9948
NPI assigned
Apr 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Vikram R Shukla, MDNPI 1275599649
Title
Sole Proprietor
Phone
(704) 868-8988

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 33304 NC Primary

Addresses

Primary practice location

839 Majestic CT
Suite 8
Gastonia, NC 28054-5147

Mailing address

1100 Verdant Ridge Cir
Belmont, NC 28012-7805
Phone (704) 868-8988

Other identifiers 4

IdentifierTypeStateIssuer
8976031MedicaidNC
11096051OtherNCCAQH ID
33304OtherNCSTATE LICENSE
2084P0804XOtherNCTAXONOMY

National Provider Directory

National Provider Directory

Locations

839 Majestic Ct
Ste 8
Gastonia, NC 28054
Phone (704) 868-8988

Interoperability endpoints

  • Direct secure messaging: vshukla@vikshuklapsychiatry.amazing-direct.com

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": "1459814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1053775189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 VERDANT RIDGE CIR",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280127805",
            "telephone_number": "704-868-8988",
            "fax_number": "704-868-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 MAJESTIC CT",
            "address_2": "SUITE 8",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280545147",
            "telephone_number": "704-868-8988",
            "fax_number": "704-868-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIKRAM R. SHUKLA, MD CHILD, ADOLESCENT & ADULT PSYCHIATRY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-05",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "SHUKLA",
        "authorized_official_first_name": "VIKRAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "704-868-8988",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "33304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8976031",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11096051",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "33304",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "2084P0804X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.