Active NPI
Pranay Ramesh Shah, ATC/L
- Athletic Trainer
- Buford, GA
National Provider Identifier
1467736348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT001910
- Practice address
- 4450 Nelson Brogdon Blvd
Suite D1
Buford, GA 30518-3447 - Phone
- (770) 793-9999
- Fax
- (877) 619-3810
- NPI assigned
- Oct 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001910 | GA | Primary |
Addresses
Primary practice location
4450 Nelson Brogdon Blvd
Suite D1
Buford, GA 30518-3447
Mailing address
4450 Nelson Brogdon Blvd
Suite D1
Buford, GA 30518-3447
Phone (770) 793-9999
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT001910 | GA | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sugar Hill Wellness Center Pain & Rehab LLC | Past | 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.
-
- Physical Medicine & Rehabilitation Physician
- Buford, GA
- NPI 1326323668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1467736348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4450 NELSON BROGDON BLVD",
"address_2": "SUITE D1",
"city": "BUFORD",
"state": "GA",
"postal_code": "305183447",
"telephone_number": "770-793-9999",
"fax_number": "877-619-3810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 NELSON BROGDON BLVD",
"address_2": "SUITE D1",
"city": "BUFORD",
"state": "GA",
"postal_code": "305183447",
"telephone_number": "770-793-9999",
"fax_number": "877-619-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "PRANAY",
"middle_name": "RAMESH",
"credential": "ATC/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-10",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "GA",
"license": "AT001910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.