Individual provider Active NPI

Enayat K Shirazi

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Richmond, IN
National Provider Identifier
1437420296
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
01024272A Issued in IN
Practice address
3996 Quail Hill Dr
Richmond, IN 47374-7826
Phone
(765) 966-4488
NPI assigned
Jan 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 01024272A IN Primary

Addresses

Primary practice location

3996 Quail Hill Dr
Richmond, IN 47374-7826

Mailing address

3996 Quail Hill Dr
Richmond, IN 47374-7826
Phone (765) 966-4488

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01024272AINMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1437420296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3996 QUAIL HILL DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473747826",
            "telephone_number": "765-966-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3996 QUAIL HILL DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473747826",
            "telephone_number": "765-966-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "ENAYAT",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-25",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IN",
            "license": "01024272A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.