Gowd Shiva Nagaraj, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

2009-00324 Issued in NC

Practice address

2131 S 17TH St
Wilmington, NC 28401-7407

Phone

(910) 343-7074

NPI assigned

Mar 21, 2007

Last updated

Oct 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pathology

Education

Other, 1964

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260
• HCA Florida Lawnwood Hospital Hospital, Fort Pierce, FL, CCN 100246

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Integrated Regional Laboratories Pathology Services, LLC

  dba IRL Pathology Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlantis, FL
  • NPI 1942526298
  Medicare reassignment Care Compare group NPD
• Greensboro Pathology, LLC

  • Specialist
  • Greensboro, NC
  • NPI 1023084340
  Medicare reassignment NPD
• Wilmington Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Wilmington, NC
  • NPI 1205809589
  Medicare reassignment NPD
• Ameripath Hospital Services-Florida LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Clermont, FL
  • NPI 1124091509
  Medicare reassignment NPD
• Greensboro Pathology, LLC

  • Clinical Medical Laboratory
  • Greensboro, NC
  • NPI 1952396202
  NPD
• Ameripath Hospital Services-Florida LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Myers, FL
  • NPI 1255304689
  NPD
• Ameripath Hospital Services-Florida LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Myers, FL
  • NPI 1518735208
  NPD
• Mid-Atlantic Pathology Services, Inc.

  • Clinical Medical Laboratory
  • McLean, VA
  • NPI 1245302009

  Anatomic Pathology & Clinical Pathology

  NPD
• Pathmed Associates LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlantis, FL
  • NPI 1083785703
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Florida, Inc.

  dba HCA Florida St. Lucie Hospital

  • General Acute Care Hospital
  • Port St Lucie, FL
  • NPI 1538115696
  Care Compare affiliation
• Lawnwood Medical Center Inc

  dba HCA Florida Lawnwood Hospital

  • General Acute Care Hospital
  • Fort Pierce, FL
  • NPI 1568409647
  Care Compare affiliation

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1275659641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20169",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-343-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGARAJ",
        "first_name": "GOWD",
        "middle_name": "SHIVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2009-00324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911282",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "152K9",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.
• 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.