Active NPI
Madhuri Shah, M.D.
- Clinic/Center
- Salt Lake City, UT
National Provider Identifier
1124156906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 164193-1203
- Practice address
- 515 S 400 E
Salt Lake City, UT 84111-3501 - Phone
- (801) 363-3616
- Fax
- (801) 363-9051
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 164193-1203 | UT | Primary |
Addresses
Primary practice location
515 S 400 E
Salt Lake City, UT 84111-3501
Mailing address
515 So 400 E
Salt Lake City, UT 84111-3501
Phone (801) 363-3616
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164193-1203 | UT | MD | Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124156906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 SO 400 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841113501",
"telephone_number": "801-363-3616",
"fax_number": "801-363-9051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 S 400 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841113501",
"telephone_number": "801-363-3616",
"fax_number": "801-363-9051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "MADHURI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "UT",
"license": "164193-1203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.