Serena Anita Shah, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL6525 Issued in FL

Practice address

4440 Old Tampa Hwy
Lakeland, FL 33811-1135

Phone

(999) 999-9999

NPI assigned

Jan 4, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1568935336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 OLD TAMPA HWY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 OLD TAMPA HWY",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111135",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 Valley Ave NW",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983712515",
            "country_code": "US",
            "telephone_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SERENA",
        "middle_name": "ANITA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-04",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL6525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aditya Shah, MD
• Hina A Shah, RPH
• Manasi Samir Shah, MD
• Mohan M Shah, MD
• Ramesh P Shah, MD
• Shrinand Salil Shah
• Dilip Shahani, PA-C
• Raji Shaher, MD
• Khurram Shahjehan, MD
• Ali Shahriari

• Athletic Trainer in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.