Shashi Madan MD PC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

037279 Issued in GA

Legal business name

SHASHI MADAN MD PC

Practice address

135 N Oak St
Jackson, GA 30233-1942

Phone

(770) 775-7675

NPI assigned

Jun 22, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Sylvia Thompson

Title

Office Masnager

Phone

(770) 775-7675

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shashi Madan, MD

  • Internal Medicine Physician
  • Jackson, GA
  • NPI 1740359629
  Medicare reassignment NPD

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1801117007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331942",
            "telephone_number": "770-775-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASHI MADAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "OFFICE MASNAGER",
        "authorized_official_telephone_number": "770-775-7675",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "037279",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "037279",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "037279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000568554B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Jackson, GA
• Providers in Jackson, GA by specialty
• Health Maintenance Organization in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.