Soroush Vahdati-Shams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-16270 Issued in NC

Practice address

322 Main St
Prospect Hill, NC 27314-9438

Phone

(336) 562-3311

NPI assigned

Oct 30, 2024

Last updated

Jul 16, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1477375491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "PROSPECT HILL",
            "state": "NC",
            "postal_code": "273149438",
            "telephone_number": "336-562-3311",
            "fax_number": "336-562-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "PROSPECT HILL",
            "state": "NC",
            "postal_code": "273149438",
            "telephone_number": "336-562-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHDATI-SHAMS",
        "first_name": "SOROUSH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-30",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piedmont Health Services, Inc. (Prospect Hill CHC Dental)
• Piedmont Health Services, Inc. (Prospect Hill CHC Pharmacy)
• Evelyn Ponce Quintero, LCSW-A
• Caleb Amos Smith
• Colton Turner, RN, VA-BC, CM
• Gregory Val Wheatley, RD
• Rebecca Pettigrew Zidman, MS, RDN, LDN
• Cory W Zirkel, DDS

• Physician Assistant in Prospect Hill, NC
• Providers in Prospect Hill, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.