Individual provider Active NPI

Shahid Iqbal, M.D.

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1619965258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37677 Issued in TN
Practice address
3812 Tennessee Ave
Chattanooga, TN 37409
Phone
(423) 821-1177
Fax
(423) 821-1188
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X GA53071 GA
Family Medicine Physician 207Q00000X 37677 TN Primary

Addresses

Primary practice location

3812 Tennessee Ave
Chattanooga, TN 37409

Mailing address

3319 Forest Shadows Dr
Chattanooga, TN 37421-2801
Phone (423) 892-0680

Other identifiers 1

IdentifierTypeStateIssuer
3337823MedicaidTN

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 Medicine

State licenses

LicenseStateTypeSpecialty
37677TNMDLicensed Practical Nurse
GA53071GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HMC Physician Billing LLC Past Accepting new patients
Dr Anthony a Fernandez MD PA Past Accepting new patients
Healthforce Corporation Family Medicine Past Accepting new patients
Crossroads Urgent Care PLLC Family Medicine Past Accepting new patients
Cleveland Medical Clinic Inc Family Medicine Past Accepting new patients
Shahid Ali Iqbal MD PA Past Accepting new patients
Georgia Department of Human Resources PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619965258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 FOREST SHADOWS DR",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212801",
            "telephone_number": "423-892-0680",
            "fax_number": "423-821-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 TENNESSEE AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37409",
            "telephone_number": "423-821-1177",
            "fax_number": "423-821-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQBAL",
        "first_name": "SHAHID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "GA53071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "37677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3337823",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.