Shabnam Qasim Mdpa

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K9397 Issued in TX

Legal business name

SHABNAM QASIM MDPA

Practice address

4819 River Oaks Blvd
Fort Worth, TX 76114

Phone

(817) 626-9744

Fax

(817) 626-9962

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Roshan Jagthap

Title

Credentialing Manager

Phone

(817) 532-3203

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13752/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Kathryn Carrillo, DNP, FNP-C

  • Family Nurse Practitioner
  • Austin, TX
  • NPI 1487343349
  NPD

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1396792602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 RIVER OAKS BLVD",
            "city": "RIVER OAKS",
            "state": "TX",
            "postal_code": "761142714",
            "telephone_number": "817-626-9744",
            "fax_number": "817-626-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 RIVER OAKS BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76114",
            "telephone_number": "817-626-9744",
            "fax_number": "817-626-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHABNAM QASIM MDPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "JAGTHAP",
        "authorized_official_first_name": "ROSHAN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "817-532-3203"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1634057",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Belaynesh Seyoum
• Sghpc-Sa, LLC
• Shaan Dental PLLC
• Ashley E Shabareck, NP
• Adrienne Marie Shabazz, LBSW
• Nabeel M Shabout, M.D.
• Janet Shackelford, MD
• Jael Shackleford, LPC ASSOCIATE
• Edward Charles Shadiack III, D.O.
• Burton Alexander Shadow

• Internal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.