Individual provider Active NPI

Mehul Hemant Shah, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Concord, NC
National Provider Identifier
1700834058
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2019-02737 Issued in NC
Practice address
101 Cabarrus Ave E
Concord, NC 28025-3699
Phone
(888) 849-7379
Fax
(855) 857-7333
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01047350A IN
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2019-02737 NC Primary

Addresses

Primary practice location

101 Cabarrus Ave E
Concord, NC 28025-3699

Mailing address

101 Cabarrus Ave E
Concord, NC 28025-3699
Phone (888) 849-7379

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
I20200205001420 NC Practitioner - Internal Medicine 0244461788

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047350AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physicians Group of North Carolina PLLC CurrentSince Aug 12, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

7830 N Point Blvd
Winston Salem, NC 27106
Phone (743) 223-3400

Organizations & group practices 1

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1700834058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MEHUL",
        "middle_name": "HEMANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01047350A",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2019-02737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.