Active NPI
Harsh Shah
- Dentist
- Port Royal, SC
National Provider Identifier
1245669977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.023886
- Practice address
- 2200 Preserve Ave W
Apt 2231
Port Royal, SC 29935-2524 - Phone
- (810) 357-7820
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.023886 | OH | Primary |
Addresses
Primary practice location
2200 Preserve Ave W
Apt 2231
Port Royal, SC 29935-2524
Mailing address
2200 Preserve Ave W
Apt 2231
Port Royal, SC 29935-2524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150713002427 | TX | Order and Referring Only - Dentist | 1658684188 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.023886 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1245669977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 PRESERVE AVE W",
"address_2": "APT 2231",
"city": "PORT ROYAL",
"state": "SC",
"postal_code": "299352524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 PRESERVE AVE W",
"address_2": "APT 2231",
"city": "PORT ROYAL",
"state": "SC",
"postal_code": "299352524",
"telephone_number": "810-357-7820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "HARSH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.023886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Royal, SC
- Vandit Sardana, M.SC., MD, FRCSC
- Lika J Schrock, PA
- Sea Island Cancer Center
- Sea Island Healthcare, LLC
- Sea Island Rehabilitation, PA
- Katapadi Surendra Shenoy, M.D.
- James Earl Simmons, M.D.
- Marlo Monique Smith, MD
- South Carolina CVS Pharmacy LLC (CVS Pharmacy #03826)
- Sprenger Healthcare of Port Royal, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.