Shanti Portia Ganesh, MD, MPH

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

27395 Issued in WV

Practice address

1540 Spring Valley Dr
PM&R Department (117)
Huntington, WV 25704-9300

Phone

(304) 429-6741

NPI assigned

Sep 13, 2007

Last updated

Jan 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1174718076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "address_2": "PM&R DEPARTMENT (117)",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049300",
            "telephone_number": "304-429-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 SPRING VALLEY DR",
            "address_2": "PM&R DEPARTMENT (117)",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257049300",
            "telephone_number": "304-429-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESH",
        "first_name": "SHANTI",
        "middle_name": "PORTIA",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125050793",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036123418",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WV",
            "license": "27395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Gallimore
• Julia Galloway-Fanelli, PHARMD
• Courtney N Gamble
• Neha Gami
• Justin Gandee
• Amy M. Gannon, RDLD
• Stephanie Gao, MD
• Gardner Enterprises (nicholas county ems)
• Macala Gardner
• Richard D Gardner, PA-C

• Physical Medicine & Rehabilitation Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Physical Medicine & Rehabilitation Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.