Organization Active NPI

North Naples Internal Medicine LLC

  • Primary Care Clinic/Center
  • Naples, FL
National Provider Identifier
1255768164
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTH NAPLES INTERNAL MEDICINE LLC
Practice address
10621 Airport Pulling Rd N
Suite 1
Naples, FL 34109-1599
Phone
(239) 330-9999
Fax
(239) 330-1473
NPI assigned
Oct 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Authorized official

Name
Dr. Michael S Shahla, MDNPI 1548480270
Title
Manager/Owner
Phone
(239) 287-7640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

10621 Airport Pulling Rd N
Suite 1
Naples, FL 34109-1599

Mailing address

10621 Airport Pulling Rd N
Suite 1
Naples, FL 34109-1599
Phone (239) 330-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131203000460 FL Part B Supplier - Clinic/Group Practice 5395971089 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2068117North Naples Internal Medicine LLC10621 Airport Pulling Rd N Ste 1, Naples, FL 34109Certificate of waiverOct 27, 2027

National Provider Directory

National Provider Directory

Locations

10621 Airport Rd N
Ste 1
Naples, FL 34109
Phone (239) 330-9999

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1255768164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10621 AIRPORT PULLING RD N",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341091599",
            "telephone_number": "239-330-9999",
            "fax_number": "239-330-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10621 AIRPORT PULLING RD N",
            "address_2": "SUITE 1",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341091599",
            "telephone_number": "239-330-9999",
            "fax_number": "239-330-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH NAPLES INTERNAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "SHAHLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "239-287-7640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.