Rupa Shetty LLC

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

27604 Issued in SC

Legal business name

RUPA SHETTY LLC

Practice address

237 Avenue of the Palms
Myrtle Beach, SC 29579-1247

Phone

(843) 461-6133

Fax

(843) 234-6100

NPI assigned

Nov 12, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Thomas L Ryba

Title

Member

Phone

(843) 461-6133

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rupa Ravindra Shetty, M.D.

  • Psychiatry Physician
  • Myrtle Beach, SC
  • NPI 1962428235

  Child & Adolescent Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1205137817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 AVENUE OF THE PALMS",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295791247",
            "telephone_number": "843-461-6133",
            "fax_number": "843-234-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 AVENUE OF THE PALMS",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295791247",
            "telephone_number": "843-461-6133",
            "fax_number": "843-234-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUPA SHETTY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-12",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "RYBA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "843-461-6133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SC",
            "license": "27604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WACCAMAW CENTER FOR MENTAL HEALTH",
            "identifier": "3344",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Ruggiero
• Raleigh Norean Rumley, D.O.
• Rummel Chiropractic Center, LLC
• Jeannine Rummel, D.C.
• Shannon Rumpf
• Jan C Rusenko
• Challis Evelyn Russell, MA, LPC
• Jamie Russell
• Carol K Russo, LMFT
• Brianna Ryan

• Child & Adolescent Psychiatry Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Child & Adolescent Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.