Individual provider Active NPI

Nodar Shakarashvili, PT

  • Physical Medicine & Rehabilitation Physician
  • Solon, OH
National Provider Identifier
1457760167
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT. 014864 Issued in OH
Practice address
33790 Bainbridge Rd Ste 205
Solon, OH 44139-2982
Phone
(440) 248-9255
Fax
(440) 248-3608
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT. 014864 OH Primary

Addresses

Primary practice location

33790 Bainbridge Rd Ste 205
Solon, OH 44139-2982

Mailing address

4540 Anderson Rd
South Euclid, OH 44121-3867
Phone (440) 533-5889

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

State licenses

LicenseStateTypeSpecialty
PT. 014864OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Body Technic Systems, Inc. PastSince Apr 1, 2015 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1457760167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 ANDERSON RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213867",
            "telephone_number": "440-533-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33790 BAINBRIDGE RD STE 205",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441392982",
            "telephone_number": "440-248-9255",
            "fax_number": "440-248-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKARASHVILI",
        "first_name": "NODAR",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "PT. 014864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Solon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.