Individual provider Active NPI

Foram Ashwinkumar Shah, M.D.

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1710113535
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2014026427 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804
Phone
(417) 820-2600
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2014026427 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804

Mailing address

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150402001840 MO Practitioner - Family Practice 2163566704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600

940 W Mount Vernon St
100 MC Laboratory Services Nixa
Nixa, MO 65714-9613
Phone (417) 724-5220

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Mercy Clinic Springfield Communities Family Medicine CurrentSince May 12, 2020 Accepting new patients
Mercy Hospital Springfield Past Accepting new patients

Locations

940 W Mount Vernon St
Ste 100
Nixa, MO 65714
Phone (417) 724-5220

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Interoperability endpoints

  • Direct secure messaging: foram.shah@cernerdirect.coxhealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1710113535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-820-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "FORAM",
        "middle_name": "ASHWINKUMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2014026427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.