NPIMap

Organization Active NPI

Village Pediatrics at Vickery

  • Pediatrics Physician
  • Cumming, GA
National Provider Identifier
1518445410
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
68556 Issued in GA
Legal business name
VILLAGE PEDIATRICS AT VICKERY
Practice address
7185 Colfax Aveune
Suite 200
Cumming, GA 30040
Phone
(678) 990-3362
Fax
(678) 550-9587
NPI assigned
Aug 2, 2018
Last updated
Aug 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Dr. Shalini Mala Shah, MDNPI 1649409244
Title
Physician/Owner
Phone
(678) 523-8594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 68556 GA Primary

Addresses

Primary practice location

7185 Colfax Aveune
Suite 200
Cumming, GA 30040

Mailing address

6515 Wesley Hughes Rd
Cumming, GA 30040-6526
Phone (678) 523-8594

National Provider Directory

National Provider Directory

Locations

7165 Colfax Ave
Cumming, GA 30040
Phone (678) 990-3362

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1518445410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 WESLEY HUGHES RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406526",
            "telephone_number": "678-523-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7185 COLFAX AVEUNE",
            "address_2": "SUITE 200",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-990-3362",
            "fax_number": "678-550-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PEDIATRICS AT VICKERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SHALINI",
        "authorized_official_middle_name": "MALA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "678-523-8594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "68556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.