Shalomim Yahoshua Halahawi, NMD DPH DFM D.TCM

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

SDC-1208589 Issued in ZZ

Practice address

4827 Old National Hwy # 10016
College Park, GA 30337-6234

Phone

(678) 909-4422

NPI assigned

Oct 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 14

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1366778177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 CYPRESS PKWY",
            "address_2": "1108",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593328",
            "telephone_number": "678-909-4422",
            "fax_number": "866-357-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4827 OLD NATIONAL HWY # 10016",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303376234",
            "telephone_number": "678-909-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALAHAWI",
        "first_name": "SHALOMIM",
        "middle_name": "YAHOSHUA",
        "name_prefix": "Dr.",
        "credential": "NMD DPH DFM D.TCM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "FL",
            "license": "012710311976-PCFL",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": "LIC NO.10311976LPM",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "NUT-012710311976FL",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "ZZ",
            "license": "10311976PNNT",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ZZ",
            "license": "MFS1102210797",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "FL",
            "license": "HE-04012016-103176",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "ZZ",
            "license": "750127-1076PHE",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "DC",
            "license": "NAT#1000888",
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "FL",
            "license": "0127-HOM-1031976FLA",
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "GA",
            "license": "LIC.10311976P-MD",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "ZZ",
            "license": "D-1130-M1PK",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "ZZ",
            "license": "SDCL/MIIM/ISD1208588",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ZZ",
            "license": "SDC-1208589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ASSOCIATION OF INTEGRATIVE & PASTORAL MEDICINE",
            "identifier": "LIC#10311976PMD",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA DEPARTMENT OF COMMUNITY HEALTH CLIA REGISTRATION",
            "identifier": "11D2003757",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Lee Green-Muldrow, M.D.
• Gina Green
• Andre Griggs, LAPC
• Ratima Guest-Smith, LPC
• Yolanda Eloine Hacker, MD
• Gwendolyn B Hall, LPC
• Jervon Hamilton
• Kelvin Hamner, M.D.
• Pamela Hapson
• Annette Marie Harden Taylor, NURSE PRACTITIONER

• Family Medicine Physician in College Park, GA
• Providers in College Park, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.