Individual provider Active NPI

Kant Shah, MD

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1467614826
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2011-01072 Issued in NC
Practice address
2 Columbia Dr
J402
Tampa, FL 33606-3508
Phone
(813) 844-7412
NPI assigned
Jun 27, 2008
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2011-01072 NC Primary

Addresses

Primary practice location

2 Columbia Dr
J402
Tampa, FL 33606-3508

Mailing address

2 Columbia Dr
J402
Tampa, FL 33606-3508
Phone (813) 844-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111005000012 NC Practitioner - Emergency Medicine 4981876455 Reassigns benefits to 2 organizations
I20161207001321 MI Practitioner - Emergency Medicine 4981876455 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cfvhs Ed Physicians Emergency Medicine Current Accepting new patients
Degara App, PLLC Emergency Medicine CurrentSince Oct 1, 2018 Accepting new patients
Duke University Health System, Inc. Current Accepting new patients
Duke University Health System, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Duke University Health System, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Cfvhs Ed Physicians Emergency Medicine CurrentSince Sep 4, 2011 Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: kshah234628@direct.medicine.duke.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1467614826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "J402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLUMBIA DR",
            "address_2": "J402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063508",
            "telephone_number": "813-844-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2011-01072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.