Individual provider Active NPI

Asad Riad Shamma, MD

  • Specialist
  • Vero Beach, FL
National Provider Identifier
1710189139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
57807 Issued in FL
Practice address
362 17TH St
Vero Beach, FL 32960-5690
Phone
(772) 562-9909
Fax
(772) 365-3103
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 57807 FL Primary

Addresses

Primary practice location

362 17TH St
Vero Beach, FL 32960-5690

Mailing address

362 17TH St
Vero Beach, FL 32960-5690
Phone (772) 562-9909

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57807FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710189139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 17TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605690",
            "telephone_number": "772-562-9909",
            "fax_number": "772-365-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 17TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605690",
            "telephone_number": "772-562-9909",
            "fax_number": "772-365-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMMA",
        "first_name": "ASAD",
        "middle_name": "RIAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "57807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.