Organization Active NPI

Shah Osteopathy, PLLC

  • Internal Medicine Physician
  • High Point, NC
National Provider Identifier
1285306852
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SHAH OSTEOPATHY, PLLC
Practice address
2040 Brevard Rd
High Point, NC 27263-1702
Phone
(630) 730-4866
NPI assigned
Oct 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Dr. Pratik Shah, DONPI 1144589466
Title
Physician
Phone
(630) 730-4866

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2040 Brevard Rd
High Point, NC 27263-1702

Mailing address

5304 Sequoia CT
Greensboro, NC 27455-2184
Phone (630) 730-4866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211123001148 NC Part B Supplier - Clinic/Group Practice 7517356090 Receives reassigned benefits from 1 practitioner
Practice locations: High Point, NC

National Provider Directory

National Provider Directory

Locations

2941 Battleground Ave
#38042
Greensboro, NC 27408

2040 Brevard Rd
High Point, NC 27263
Phone (630) 730-4866

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1285306852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 SEQUOIA CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552184",
            "telephone_number": "630-730-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 BREVARD RD",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272631702",
            "telephone_number": "630-730-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAH OSTEOPATHY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PRATIK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "630-730-4866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.