Rahman Shah, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME140805 Issued in FL

Practice address

2202 State Ave Ste 207
Panama City, FL 32405-4582

Phone

(850) 872-3939

Fax

(850) 872-3938

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, FL, MS3 enrollments

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 3

Specialty

Interventional Cardiology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rahmanshah@sccpc.allscriptsdirect.net

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.

• Specialty Physician Group LLC

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1174842181

  MS

  Medicare reassignment Care Compare group NPD
• North Brevard Medical Support, Inc

  • Multi-Specialty Clinic/Center
  • Titusville, FL
  • NPI 1609834886
  Medicare reassignment NPD
• Sutherland Cardiology Clinic, P.C.

  • Specialist
  • Germantown, TN
  • NPI 1740391804
  NPD
• Covenant Counseling of South Carolina

  • Professional Counselor
  • Summerville, SC
  • NPI 1073732822
  NPD (past)
• Synergy Counseling Services LLC

  • Professional Counselor
  • Summerville, SC
  • NPI 1801838552
  NPD (past)

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

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Chippenham & Johnston-Willis Hospitals Inc

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation
• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1780632380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE STE 207",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054582",
            "telephone_number": "850-872-3939",
            "fax_number": "850-872-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 STATE AVE STE 207",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054582",
            "telephone_number": "850-872-3939",
            "fax_number": "850-872-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAHMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-01-26",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME140805",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME140805",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "42984",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MA",
            "license": "230336",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116023378",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME140805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONN PHYSICIAN LICENSE #",
            "identifier": "043649",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RAHMAN.SHAH@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "2202 State Ave Ste 207",
            "city": "Panama City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324054582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Corey J Seymour, IDC
• Muhammad Tarik Shaaban, M.D.
• Joanne Shafer
• Donna Shaffer, LMHC
• Robert Dale Shaffer Sr., NBC-HIS
• Mai Talal Shaito, AUD.
• Maged Shalaby
• Marlee Alayna Shaling, BSN RN
• Camile A Shamblin, MSN FNP-C
• Damon Lee Shamblin, DPT

• Interventional Cardiology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.