Shaym Puppala, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31120 Issued in SC

Practice address

1202 E Butler Road
Greenville, SC 29607-5910

Phone

(864) 640-0009

Fax

(864) 558-0589

NPI assigned

Jul 9, 2006

Last updated

Mar 4, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1861425001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 WOODRUFF ROAD",
            "address_2": "SUITE 2100 #127",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075959",
            "telephone_number": "864-640-0009",
            "fax_number": "864-558-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E BUTLER ROAD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075910",
            "telephone_number": "864-640-0009",
            "fax_number": "864-558-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUPPALA",
        "first_name": "SHAYM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "31120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311200",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.