Individual provider Active NPI

Kena Shah, D.O.

  • Allergy & Immunology Physician
  • Charlotte, NC
National Provider Identifier
1356604169
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
37400027 Issued in NC
Practice address
2600 E 7TH St Unit a
Charlotte, NC 28204-4398
Phone
(704) 372-7900
Fax
(704) 376-2216
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 90061 SC
Allergy & Immunology Physician 207K00000X 37400027 NC Primary

Addresses

Primary practice location

2600 E 7TH St Unit a
Charlotte, NC 28204-4398

Mailing address

PO Box 63376
Charlotte, NC 28263-2012
Phone (704) 372-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20181127002663 NY Practitioner - Allergy/Immunology 8325325061 Reassigns benefits to 1 organization
I20231115000440 SC Practitioner - Allergy/Immunology 8325325061
I20231115000529 NC Practitioner - Allergy/Immunology 8325325061

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Philadelphia Col of Osteo Med, Sewanee, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Charlotte, NC 28263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
37400027NCMDAllergy & Immunology Physician
90061SCMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Allergy & Sinus Group, PLLC Allergy & Immunology CurrentSince Oct 3, 2018 Accepting new patients
Midtown Sinus Imaging, PLLC CurrentSince Oct 3, 2018 Accepting new patients

Locations

877 Stewart Ave
Ste 5
Garden City, NY 11530
Phone (516) 794-8772

7949 Myrtle Ave
Glendale, NY 11385
Phone 21268663218309

19002 Jamaica Ave
Jamaica, NY 11423
Phone (718) 417-0207

225 E 57th St
New York, NY 10022
Phone (212) 480-4062

135 E 83rd St
Apt 1A
New York, NY 10028
Phone (212) 665-0200

55 E 87th St
Ste 1C
New York, NY 10128
Phone (212) 348-4300

1575 Hillside Ave
North New Hyde Pk, NY 11040
Phone (516) 200-1835

1500 Victory Blvd
Staten Island, NY 10301
Phone (718) 556-5550

Interoperability endpoints

  • Direct secure messaging: kshah2954167@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: kena.shah.p1@direct.caac.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1356604169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63376",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282632012",
            "telephone_number": "704-372-7900",
            "fax_number": "704-376-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E 7TH ST UNIT A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044398",
            "telephone_number": "704-372-7900",
            "fax_number": "704-376-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KENA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "SC",
            "license": "90061",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NC",
            "license": "37400027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.