Shayan Bagheri, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

204 Canton Rd
Cumming, GA 30040-2304

Phone

(770) 886-5437

NPI assigned

Jun 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFHEDD/Endpoint/AFHEDD

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

• Lakeside Pediatrics, LLC

  • Pediatrics Physician
  • Cumming, GA
  • NPI 1326317520
  NPD (past)

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

{
    "created_epoch": "1717804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1205678554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402304",
            "telephone_number": "770-886-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402304",
            "telephone_number": "770-886-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHERI",
        "first_name": "SHAYAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-08",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baby Talk Therapies, Inc.
• Backsmart Health LLC - North Ga Diagnostic & Rehab
• Melissa Genevieve Baden, CACI
• Christal Bae, LAC.
• Bob B Bagheri, M.D.
• Sayed Bahaduri
• Felicity Dwamena Baidoo
• Jaymie Bailey, PA
• Shonda Shanel Bailey, AUD
• David Andrew Bak, D.C.

• Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.