Shubha Raja, M.B.B.S.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2012032355 Issued in MO

Practice address

4045 NE Lakewood Way
Suite 130
Lees Summit, MO 64064-1799

Phone

(816) 886-2184

Fax

(816) 886-2397

NPI assigned

May 15, 2007

Last updated

May 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shubha Kharidi Former name

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: whiteoakpsychiatricservices.shubharaja@133176.advancedmd-direct.com

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.

• M a Mirza, LLC

  dba White Oak Psychiatric Services

  • Prescribing (Medical) Psychologist
  • Lee's Summit, MO
  • NPI 1376757617
  Medicare reassignment

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1336355585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14611 LINDEN ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662247803",
            "telephone_number": "913-738-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 NE LAKEWOOD WAY",
            "address_2": "SUITE 130",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641799",
            "telephone_number": "816-886-2184",
            "fax_number": "816-886-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJA",
        "first_name": "SHUBHA",
        "credential": "M.B.B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2012032355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUBHA",
            "last_name": "KHARIDI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Child & Adolescent Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.