Active NPI
Shaden Daloub
- Student in an Organized Health Care Education/Training Program
- Huntington, WV
National Provider Identifier
1679144281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1600 Medical Center Dr
Huntington, WV 25701-3656 - Phone
- (304) 691-1824
- NPI assigned
- Jul 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 9411701 | KS | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1600 Medical Center Dr
Huntington, WV 25701-3656
Mailing address
3901 Rainbow Blvd # Ms 3006
Kansas City, KS 66160-8500
Phone (913) 588-3827
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210910000904 | WV | Order and Referring Only - Cardiovascular Disease (Cardiology) | 6204232614 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9411701 | KS | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1679144281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD # MS 3006",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661608500",
"telephone_number": "913-588-3827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 MEDICAL CENTER DR",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257013656",
"telephone_number": "304-691-1824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALOUB",
"first_name": "SHADEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-06",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "KS",
"license": "9411701",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.