NPIMap

Individual provider Active NPI

Shalin C Shah, D.O.

  • Interventional Pain Medicine Physician
  • Augusta, GA
National Provider Identifier
1407156953
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
762671 Issued in GA
Practice address
1367 Interstate Pkwy
Augusta, GA 30909-5626
Phone
(404) 920-4950
Fax
(404) 920-4959
NPI assigned
Nov 1, 2010
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 58.003847 OH
Anesthesiology Physician 207L00000X 37600 SC
Anesthesiology Physician 207L00000X 72671 GA
Interventional Pain Medicine Physician 208VP0014X 762671 GA Primary

Addresses

Primary practice location

1367 Interstate Pkwy
Augusta, GA 30909-5626

Mailing address

3390 Peachtree Rd NE Ste 1500
Atlanta, GA 30326-2822
Phone (404) 920-4950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150306001208 GA Practitioner - Anesthesiology 5991021123 Reassigns benefits to 3 organizations
I20150709000733 SC Practitioner - Anesthesiology 5991021123

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio University, College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

1388 Wellbrook Necir a
Conyers, GA 30012-3872
Phone (770) 929-9033

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
74.46
Promoting interoperability
99
Improvement activities
40
Cost
71.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72671GAMDAnesthesiology Physician
58.003847OHMDAnesthesiology Physician
37600SCMDAnesthesiology Physician
762671GAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Interventional Spine and Pain Management Center PC Interventional Pain Medicine CurrentSince Oct 1, 2015 Accepting new patients
The Interventional Spine and Pain Management Center, PC Interventional Pain Medicine CurrentSince Oct 1, 2015 Accepting new patients
CPM Labs, LLC Current Accepting new patients
Piedmont Anesthesia LLC Anesthesiology CurrentSince Oct 9, 2022 Accepting new patients
Anesthesia and Pain Medicine Anesthesiology Past Accepting new patients
JMB Pharmacy, LLC Past Accepting new patients

Locations

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1367 Interstate Pkwy
Augusta, GA 30909
Phone (706) 863-3135

3870 Medical Park Dr
Ste 110
Austell, GA 30106
Phone (404) 920-4972

812 S Park St
Ste 5A
Carrollton, GA 30117
Phone (770) 834-9050

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

110 Evans Mill Dr
Ste 805
Dallas, GA 30157

3400 Chapel Hill Rd
Ste 101
Douglasville, GA 30135

4799 Sugarloaf Pkwy
Ste G100
Lawrenceville, GA 30044

1295 Hembree Rd
Ste A105
Roswell, GA 30076

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

6920 McGinnis Ferry Rd
Ste 360B
Suwanee, GA 30024

300 Parkbrooke Pl
Ste 390
Woodstock, GA 30189

Interoperability endpoints

  • Direct secure messaging: shalin.shah@ispm.eclinicaldirectplus.com

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1407156953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE RD NE STE 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822",
            "telephone_number": "404-920-4950",
            "fax_number": "404-920-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095626",
            "telephone_number": "404-920-4950",
            "fax_number": "404-920-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHALIN",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "58.003847",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "37600",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "72671",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "762671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.