Shashank Mishra, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2003-01021 Issued in NC

Practice address

4815 Berewick Town Center Dr Ste C&D
Charlotte, NC 28278-6733

Phone

(980) 337-4652

Fax

(980) 337-4653

NPI assigned

Jun 30, 2005

Last updated

Oct 25, 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 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC, NC2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: smishra@crhn.cernerdirect.com
• Direct secure messaging: smishra769113@direct.novanthealth.org

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.

• Columbus Emergency Group LLC

  • Emergency Medicine Physician
  • Whiteville, NC
  • NPI 1588813786
  Medicare reassignment NPD
• Jefferson Emergency Services, PLLC

  • Emergency Medicine Physician
  • Jefferson, NC
  • NPI 1720495336
  Medicare reassignment NPD
• Yadkin Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Elkin, NC
  • NPI 1417443771
  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• App of South Carolina Ed PLLC

  • Emergency Medicine Physician
  • Hartsville, SC
  • NPI 1457878084
  Medicare reassignment NPD
• Carolina Family Care, Inc

  dba MUSC Physicians PCP

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment NPD
• Prisma Health Tuomey

  dba Prisma Health Emergency Physicans Tuomey

  • Emergency Medicine Physician
  • Sumter, SC
  • NPI 1548625593
  Medicare reassignment NPD
• Carolina Family Care, Inc

  dba MUSC Physicians PC

  • Internal Medicine Physician
  • Lancaster, SC
  • NPI 1275564098

  Family Medicine

  NPD
• Prisma Health Tuomey

  dba Prisma Health Tuomey Acute Rehabilitation

  • Rehabilitation Hospital Unit
  • Sumter, SC
  • NPI 1609895663
  NPD
• Anson Regional Medical Services , Inc

  • Health Maintenance Organization
  • Wadesboro, NC
  • NPI 1669479077
  NPD (past)
• Anson Regional Medical Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Monroe, NC
  • NPI 1649540105

  Family Medicine

  NPD (past)
• Carolina Medicorp Enterprises, LLC

  dba Novant Health GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Huntersville, NC
  • NPI 1972488427
  NPD (past)

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1386641728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BEREWICK TOWN CENTER DR STE C&D",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786733",
            "telephone_number": "980-337-4652",
            "fax_number": "980-337-4653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHRA",
        "first_name": "SHASHANK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2003-01021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1359A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891359A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smishra769113@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4815 Berewick Town Center Dr Ste C&d",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282786733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy L. Mishler, LCSW
• Jeff Randall Mishoe, D.MIN.
• Isha Dua Mishra, MD
• Kaycee Michele Mishra
• Manisha Mishra, DO
• Shelley S Misiaveg, OTR/L
• Corey Michael Miskevics, PMHNP-BC
• Alexis Taylor Mislevy, PA
• Dipika Misra, M.D.
• Satish Kumar Misra, MD

• Family Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.