Active NPI
Soheil Jamshidi, MD
- Vascular Surgery Physician
- Suwanee, GA
National Provider Identifier
1679189443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 86731
- Practice address
- 2685 Peachtree Pkwy Ste 320
Suwanee, GA 30024-1048 - Phone
- (770) 771-5260
- Fax
- (770) 771-5269
- NPI assigned
- Sep 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 86731 | GA | Primary |
Addresses
Primary practice location
2685 Peachtree Pkwy Ste 320
Suwanee, GA 30024-1048
Mailing address
2685 Peachtree Pkwy Ste 320
Suwanee, GA 30024-1048
Phone (770) 771-5260
Other practice location 1
1357 Hembree Rd Ste 240
Roswell, GA 30076-5726
Phone (770) 771-5260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003241006B | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Suwanee | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1679189443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2685 PEACHTREE PKWY STE 320",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241048",
"telephone_number": "770-771-5260",
"fax_number": "770-771-5269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2685 PEACHTREE PKWY STE 320",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241048",
"telephone_number": "770-771-5260",
"fax_number": "770-771-5269"
}
],
"practiceLocations": [
{
"address_1": "1357 Hembree Rd Ste 240",
"address_purpose": "LOCATION",
"city": "Roswell",
"state": "GA",
"postal_code": "300765726",
"country_code": "US",
"telephone_number": "770-771-5260",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAMSHIDI",
"first_name": "SOHEIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-17",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "GA",
"license": "86731",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003241006B",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Suwanee",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2685 Peachtree Pkwy Ste 320",
"city": "Suwanee",
"state": "GA",
"country_code": "US",
"postal_code": "300241048",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.