Jayraj C Shah, MD

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

MD12977 Issued in TN

Practice address

416 N Locust Ave
Lawrenceburg, TN 38464-3518

Phone

(931) 762-8588

Fax

(931) 766-1010

NPI assigned

Aug 15, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: shah_jayraj_-_md@yourcarecommunity.org

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1457364671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 508",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384640508",
            "telephone_number": "931-762-8588",
            "fax_number": "931-766-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N LOCUST AVE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384643518",
            "telephone_number": "931-762-8588",
            "fax_number": "931-766-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAYRAJ",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TN",
            "license": "MD12977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3182622",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BCBS-TN 0000924",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shalyn Rae Self, RN
• Christy Sells, LPN
• Seven Springs and Sports Medicine
• Seven Springs Orthopaedics, PC
• Samuel L Shackelford, DDSPC
• Sheldon T. Blood, D.D.S.,P.C.
• Tarah Shae Shelton, RN
• Timothy Wade Shelton, FNP-C
• Derryl Lynn Shimer
• Matthew Neal Sides

• Adolescent Medicine (Internal Medicine) Physician in Lawrenceburg, TN
• Providers in Lawrenceburg, TN by specialty
• Adolescent Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.