Issam Shaker, M.D.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

017883 Issued in GA

Practice address

840 Pine St Ste 510
Macon, GA 31201-7530

Phone

(478) 633-8383

Fax

(478) 633-8390

NPI assigned

Feb 27, 2006

Last updated

Sep 9, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ishaker433256@carolinashealthcaresystem.direct-ci.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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatrics

  Medicare reassignment NPD
• Cardio Thoracic Vascular & Pediatric Surgery Assoc PC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Macon, GA
  • NPI 1366516338
  NPD (past)
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1356317598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 510",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8383",
            "fax_number": "478-633-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST STE 510",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017530",
            "telephone_number": "478-633-8383",
            "fax_number": "478-633-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKER",
        "first_name": "ISSAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "017883",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "017883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashna Shah, DMD
• Shaan Hemant Shah, M.D.
• Sheila K. Shah, D.M.D.
• Tina Marie Shaheen, CRNA
• Marika Shahid, DO
• Ashanti Shanklin
• Kindrall D Shannon
• Mohammed Aijaz Shareef, MD
• Sital Sharma
• Sharon S Jordon PC

• Pediatric Surgery Physician in Macon, GA
• Providers in Macon, GA by specialty
• Pediatric Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.