Jetal Shukla, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5007179 Issued in NC

Practice address

431 Keisler Dr Ste 100
Cary, NC 27518-7064

Phone

(919) 468-6820

Fax

(919) 468-6484

NPI assigned

Sep 23, 2014

Last updated

Aug 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Eventus Wholehealth PLLCGroup PAC ID 6002169539, 301 clinicians

Eventus WH Southeast, LLCGroup PAC ID 5496294456, 241 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medi Home Health Agency Home health agency, Raleigh, NC, CCN 347237
• Transitions Lifecare Hospice, Raleigh, NC, CCN 341523

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCBAAA/Endpoint/FCBAAA
• Direct secure messaging: jetal.shukla@shahfp.eclinicaldirectplus.com

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.

• Eventus WH Southeast, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Charlotte, NC
  • NPI 1487494811
  Medicare reassignment Care Compare group NPD
• Eventus Wholehealth, PLLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1548759392
  Medicare reassignment Care Compare group
• Eventus Value Care, LLC

  • Family Medicine Physician
  • Concord, NC
  • NPI 1013680503
  Medicare reassignment NPD
• Eventus WH PLLC Care, LLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1639990658
  NPD
• Lifesource of North Carolina

  • Internal Medicine Physician
  • Wilmington, NC
  • NPI 1811286156
  NPD
• Shah and Associates Family Practice

  • Family Medicine Physician
  • Cary, NC
  • NPI 1093737173
  NPD
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospice of Wake County, Inc.

  dba Transitions HospiceCare

  • Community Based Hospice Care Agency
  • Raleigh, NC
  • NPI 1518974609
  Care Compare affiliation
• Medical Services of America, Inc.

  dba Medi Home Health Agency

  • Home Health Agency
  • Raleigh, NC
  • NPI 1942252853
  Care Compare affiliation

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1467854224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 KEISLER DR STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187064",
            "telephone_number": "919-468-6820",
            "fax_number": "919-468-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 KEISLER DR STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187064",
            "telephone_number": "919-468-6820",
            "fax_number": "919-468-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "JETAL",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Gray Shore, FNP-C
• Megan Dorsey Shores, OTD, OTR/L
• Joseph Short, DDS
• Shotwell MD PC (Star Sleep & Wellness)
• Archana Shukla
• Jacob Shumac
• Alyssa Christine Shupe, PT, DPT
• Siah's Heart Home Care, L.L.C
• Sufia Siddique, M. D.
• Jennifer Duckett Siddle, MD

• Family Nurse Practitioner in Cary, NC
• Providers in Cary, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.