Organization Active NPI

Medical Practice, LTD.

  • Internal Medicine Physician
  • Chesapeake, VA
National Provider Identifier
1609938505
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101023718 Issued in VA
Legal business name
MEDICAL PRACTICE, LTD.
Practice address
710 Liberty St
Chesapeake, VA 23324-2637
Phone
(757) 543-6861
Fax
(757) 543-4082
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Authorized official

Name
Dharmesh K Shah, M.D.
Title
President
Phone
(757) 543-6861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0101023718 VA Primary

Addresses

Primary practice location

710 Liberty St
Chesapeake, VA 23324-2637

Mailing address

710 Liberty St
Chesapeake, VA 23324-2637
Phone (757) 543-6861

Other identifiers 4

IdentifierTypeStateIssuer
461191OtherVAANTHEM
5882401MedicaidVA
12090OtherVAOPTIMA HEALTH
110138225OtherVAMEDICARE-RAILROAD

National Provider Directory

National Provider Directory

Locations

710 Liberty St
Chesapeake, VA 23324
Phone (757) 543-6861

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1609938505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 LIBERTY ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242637",
            "telephone_number": "757-543-6861",
            "fax_number": "757-543-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LIBERTY ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242637",
            "telephone_number": "757-543-6861",
            "fax_number": "757-543-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PRACTICE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DHARMESH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-543-6861",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101023718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "461191",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5882401",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "12090",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RAILROAD",
            "identifier": "110138225",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.