Specialty Physician Partners, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

SPECIALTY PHYSICIAN PARTNERS, LLC

Practice address

13500 Ponder Lane
Frisco, TX 75035

Phone

(516) 721-7069

NPI assigned

Jan 12, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Rehan Shah, MD

Title

Owner

Phone

(516) 721-7069

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1851042725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13500 PONDER LANE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "516-721-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 PONDER LANE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "516-721-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHYSICIAN PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "REHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-721-7069",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.