Shivdharaa LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

SHIVDHARAA LLC

Practice address

3639 Lawrenceville Hwy # 7
Lawrenceville, GA 30044-4107

Phone

(404) 940-2033

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Bijal Patel, NP

Title

Owner

Phone

(678) 643-5580

Specialties & licenses 1

Addresses

Other names 1

• EVOLVE MEDICAL CARE CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Dinesh R Gandhi, MD

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1568443273
  Medicare reassignment NPD
• Bijalben Patel, FNP

  • Family Nurse Practitioner
  • Norcross, GA
  • NPI 1003472150
  Medicare reassignment NPD

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1619688660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 HAYNES CLUB CIR",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300172814",
            "telephone_number": "678-643-5580",
            "fax_number": "888-542-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 LAWRENCEVILLE HWY # 7",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300444107",
            "telephone_number": "404-940-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIVDHARAA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BIJAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-643-5580",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVOLVE MEDICAL CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EVOLVE MEDICAL CARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aisha Fatima Shine, NP
• Shining Light Behavior Health Services
• Shiningstarrs Home Care LLC
• Patrick James Shinnick, LCSW, ACSW, NCAC 1
• Ship365 Logistics Inc
• Christopher Shoji, DO
• David W. Shonkoff, MD
• David Anthony Shore, M.D.
• Lewaa Shoujaa, MD
• Michelle R Shoultz, PA-C

• Primary Care Nurse Practitioner in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.