Fereidoon Shafiei, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

54753 Issued in TN

Practice address

2050 Meadowview Pkwy
Kingsport, TN 37660-7475

Phone

(423) 230-5000

Fax

(423) 224-5035

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257

  Family Medicine

  NPD
• Wellmont Medical Associates, Inc.

  • Urgent Care Clinic/Center
  • Bristol, TN
  • NPI 1770942575
  NPD
• Wellmont Medical Associates, Inc.

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1154789030
  NPD (past)
• Internal Medicine of the Twin Cities

  • Internal Medicine Physician
  • Monroe, LA
  • NPI 1912956863
  NPD (past)
• Ipn of Arizona, PLC

  • Internal Medicine Physician
  • Glendale, AZ
  • NPI 1538119284
  NPD (past)
• Western la Emergency Physicians

  • Emergency Medicine Physician
  • Coushatta, LA
  • NPI 1689817512
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1740493113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PKWY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607475",
            "telephone_number": "423-230-5000",
            "fax_number": "423-224-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFIEI",
        "first_name": "FEREIDOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "54753",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36824",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231558",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serene Roots Wellness LLC
• David H Sewell, M. D.
• Brian David Shafer, D.O.
• Jennifer Gordon Shafer, D.O.
• Logan Alexander Shaffer, LPC-MHSP
• Aruna Shah, MD
• Neesha Nalina Shah, MSN, FNP
• Stacy Rebekah Shankle, BS
• Upama Sharma, MD
• Katherine M Sharrett, FNP-BC

• Clinical Cardiac Electrophysiology Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Clinical Cardiac Electrophysiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.