Active NPI
Gaurang Shah, D.O.
- Family Medicine Physician
- Bethel, OH
National Provider Identifier
1487666335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34-008747
- Practice address
- 3088 Angel Dr
Bethel, OH 45106-9533 - Phone
- (513) 734-6979
- Fax
- (513) 734-6210
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34-008747 | OH | Primary |
Addresses
Primary practice location
3088 Angel Dr
Bethel, OH 45106-9533
Mailing address
3088 Angel Dr
Bethel, OH 45106-9533
Phone (513) 734-6979
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2694795 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-008747 | OH | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327276800000",
"number": "1487666335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3088 ANGEL DR",
"city": "BETHEL",
"state": "OH",
"postal_code": "451069533",
"telephone_number": "513-734-6979",
"fax_number": "513-734-6210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3088 ANGEL DR",
"city": "BETHEL",
"state": "OH",
"postal_code": "451069533",
"telephone_number": "513-734-6979",
"fax_number": "513-734-6210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "GAURANG",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2012-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34-008747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2694795",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bethel, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.