Individual provider Active NPI

Haitham Shahrour, MD

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1184927444
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
75368 Issued in GA
Practice address
859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone
(404) 785-0588
Fax
(404) 785-0596
NPI assigned
Dec 8, 2010
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 75368 GA Primary

Addresses

Primary practice location

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255

Mailing address

859 Mount Vernon Hwy NE Ste 300
Atlanta, GA 30328-4255
Phone (404) 785-0588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75368GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Children's Medical Center Past Accepting new patients
Choa Multispecialty, LLC Pediatrics Past Accepting new patients
Arthur M. Blank Hospital, Inc. Past Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1184927444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 MOUNT VERNON HWY NE STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284255",
            "telephone_number": "404-785-0588",
            "fax_number": "404-785-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHROUR",
        "first_name": "HAITHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-08",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "75368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "859 Mount Vernon Hwy NE Ste 300",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.