Active NPI
Krishna J Shah, M.D.
- Clinical Medical Laboratory
- Flint, MI
National Provider Identifier
1386669588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- KS037728
- Practice address
- 6219 Farm CT
Flint, MI 48532-2115 - Phone
- (810) 449-1594
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | KS037728 | MI | Primary |
Addresses
Primary practice location
6219 Farm CT
Flint, MI 48532-2115
Mailing address
6219 Farm CT
Flint, MI 48532-2115
Phone (810) 449-1594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1589410 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KS037728 | MI | MD | Clinical Medical Laboratory |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386669588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6219 FARM CT",
"city": "FLINT",
"state": "MI",
"postal_code": "485322115",
"telephone_number": "810-449-1594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6219 FARM CT",
"city": "FLINT",
"state": "MI",
"postal_code": "485322115",
"telephone_number": "810-449-1594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KRISHNA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "MI",
"license": "KS037728",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1589410",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.