Individual provider Active NPI

Ankur N Shah, M.D.

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1639376528
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2008-01348 Issued in NC
Practice address
9224 Ardrey Kell Rd Ste 200
Charlotte, NC 28277-4952
Phone
(704) 316-1495
Fax
(704) 316-1496
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2008-01348 NC Primary

Addresses

Primary practice location

9224 Ardrey Kell Rd Ste 200
Charlotte, NC 28277-4952

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (844) 266-8268

Other practice location 1

12611 N Community House Rd Ste 200
Charlotte, NC 28277
Phone (704) 316-1495

Other identifiers 3

IdentifierTypeStateIssuer
NC2415MedicaidSC
1639376528MedicaidNC
5909892MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashah566319@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000617 NC Practitioner - Pediatric Medicine 2961577911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-01348NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jun 13, 2018 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince Jun 13, 2018 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

6324 Fairview Rd
Ste 350
Charlotte, NC 28210
Phone (704) 384-8600

12611 N Community House Rd
Ste 200
Charlotte, NC 28277
Phone (704) 731-1014

9224 Ardrey Kell Rd
Ste 200
Charlotte, NC 28277
Phone (704) 316-1495

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: ashah566319@direct.novanthealth.org

Organizations & group practices 4

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1639376528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9224 ARDREY KELL RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774952",
            "telephone_number": "704-316-1495",
            "fax_number": "704-316-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12611 N Community House Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28277",
            "country_code": "US",
            "telephone_number": "704-316-1495",
            "fax_number": "704-316-1496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "ANKUR",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-01348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2415",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639376528",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909892",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashah566319@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "12611 N Community House Rd Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.