Shailaja Amirishetty, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2016-00130 Issued in NC

Practice address

2525 Court Dr
Gastonia, NC 28054-2140

Phone

(704) 834-4390

Fax

(704) 834-3274

NPI assigned

Jul 13, 2011

Last updated

Apr 30, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolina Caring Hospice, Gastonia, NC, CCN 341536
• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Caromont Medical Group, Inc.

  dba CaroMont Inpatient Physicians

  • Hospitalist Physician
  • Gastonia, NC
  • NPI 1912188939
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Caromont Serious Illness Partners, LLC

  • Community Based Hospice Care Agency
  • Gastonia, NC
  • NPI 1780419523
  Care Compare affiliation
• Gaston Memorial Hospital, Incorporated

  dba CaroMont Regional Medical Center

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461974400000",
    "number": "1669760534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-834-4390",
            "fax_number": "704-834-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542140",
            "telephone_number": "704-834-4390",
            "fax_number": "704-834-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIRISHETTY",
        "first_name": "SHAILAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2016-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443055",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2016-00130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa M Wolff DDS PLLC (Wolff Family Dental)
• Rajitha Ambati, MD
• Elaine Ambrosio, NP
• America's Best Contacts & Eyeglasses
• American Homepatient, Inc.
• Corrine M Andersen
• Barbara Anderson
• Jason Drew Anderson, MSW
• Nicole Helen Anderson, CRNA
• Tiera Anderson

• Internal Medicine Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.