Active NPI
Polly Wishon-Shah, AS,RT,R,M,CT,MR
- Radiologic Technologist
- Fort Lauderdale, FL
National Provider Identifier
1821288788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 276262
- Practice address
- 6451 N Federal Hwy
Suite 700
Ft Lauderdale, FL 33308-1402 - Phone
- (800) 782-9029
- NPI assigned
- Jul 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 276262 | MO | Primary |
Addresses
Primary practice location
6451 N Federal Hwy
Suite 700
Ft Lauderdale, FL 33308-1402
Mailing address
7460B E Saint Charles Rd
Columbia, MO 65202-6801
Phone (573) 587-3426
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
- Associate of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 276262 | MO | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185494400000",
"number": "1821288788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7460B E SAINT CHARLES RD",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652026801",
"telephone_number": "573-587-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6451 N FEDERAL HWY",
"address_2": "SUITE 700",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333081402",
"telephone_number": "800-782-9029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISHON-SHAH",
"first_name": "POLLY",
"name_prefix": "Ms.",
"credential": "AS,RT,R,M,CT,MR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-27",
"last_updated": "2007-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "MO",
"license": "276262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.