Glenwood Direct Primary Care PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GLENWOOD DIRECT PRIMARY CARE PLLC

Practice address

5623 Duraleigh Rd Ste 141
Raleigh, NC 27612-2700

Phone

(919) 322-0730

Fax

(919) 615-0113

NPI assigned

Sep 1, 2023

Last updated

Sep 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Abid Ali Shah, MD

Title

Physician/Owner

Phone

(919) 605-7318

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1174309553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 DURALEIGH RD STE 141",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122700",
            "telephone_number": "919-322-0730",
            "fax_number": "919-615-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 DURALEIGH RD STE 141",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122700",
            "telephone_number": "919-322-0730",
            "fax_number": "919-615-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD DIRECT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "ABID",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "919-605-7318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.