Shangbo Guan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

044732 Issued in GA

Practice address

275 Carpenter Dr NE
Suite 100
Atlanta, GA 30328-4928

Phone

(494) 497-9739

Fax

(404) 497-9702

NPI assigned

Mar 14, 2006

Last updated

Aug 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1811965957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CARPENTER DR NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284928",
            "telephone_number": "494-497-9739",
            "fax_number": "404-497-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CARPENTER DR NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284928",
            "telephone_number": "494-497-9739",
            "fax_number": "404-497-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAN",
        "first_name": "SHANGBO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "044732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000846326B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilly Gu
• Lina Belle Gu
• Jessica Guadagno, PA-C
• Kristal Guadalupe Garcia, PA-C
• Lynn Xinhui Guan, PA-C
• Elena Marie Guardia, LMSW
• Guardian Hospice of Georgia, LLC
• Guardian Path LLC
• Guardian Physician Services LLC
• Clifford Guarnaccia, PH.D.

• Internal Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.