Shalom Pediatric Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2005-01548 Issued in NC

Legal business name

SHALOM PEDIATRIC CLINIC

Practice address

2806 Randleman Rd
Suite M
Greensboro, NC 27406-5265

Phone

(336) 574-8355

Fax

(336) 273-9192

NPI assigned

Aug 17, 2011

Last updated

Aug 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rita Obiageli Nnaemekaokoyeh, MDNPI 1861448581

Title

Medical Director

Phone

(336) 574-8355

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Rita Obiageli Nnaemekaokoyeh, M.D.

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1861448581
  NPD (past) Authorized official

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1316227739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 RANDLEMAN RD",
            "address_2": "SUITE M",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065265",
            "telephone_number": "336-574-8355",
            "fax_number": "336-273-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 RANDLEMAN RD",
            "address_2": "SUITE M",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274065265",
            "telephone_number": "336-574-8355",
            "fax_number": "336-273-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "NNAEMEKAOKOYEH",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "OBIAGELI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "336-574-8355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "2005-01548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4188",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay A. Shah, DMD
• Rudra Shah
• Chanel Shahnami
• Homa Shahnawaz, MD
• George Joseph Shalhoub, M.D.
• Bernard Shalvey, LCMHC LCAS NCC
• Ibtehal Jaralla Shamleffer, M.D
• Rony Labib Shammas, M.D.
• Ravi Shankar, MD
• Chad Shannon

• Primary Care Clinic/Center in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.