Purvi K Shah, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004989 Issued in GA

Practice address

800 Oakhurst Dr
Evans, GA 30809-3650

Phone

(706) 364-5500

Fax

(706) 364-6863

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 23, 2022 through Aug 23, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Evans Urgent Care

  • Family Medicine Physician
  • Evans, GA
  • NPI 1306987235
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861534000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2628",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308092628",
            "telephone_number": "706-364-5500",
            "fax_number": "706-364-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAKHURST DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093650",
            "telephone_number": "706-364-5500",
            "fax_number": "706-364-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PURVI",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Drake Scott, DMD
• Sonja Scott
• Joshua Screws
• Macy Salter Sepulveda
• Kirstin Shaffer, PA
• Bethany Shaw, RBT
• Kenneth Steven Shaw, O.D.
• Lisa Marie Sheehan, M.D.
• Bozeman K Sherwood, MD
• Samir Nicolas Shwayri, PHARMD

• Physician Assistant in Evans, GA
• Providers in Evans, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.