Individual provider Active NPI

Rucha Shukla

  • Neonatal-Perinatal Medicine Physician
  • Lexington, KY
National Provider Identifier
1861808271
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
50385 Issued in KY
Practice address
138 Leader Ave RM 9a
Lexington, KY 40508
Phone
(859) 218-3895
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BC 07274801978 WV
Neonatal-Perinatal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080N0001X 50385 KY Primary

Addresses

Primary practice location

138 Leader Ave RM 9a
Lexington, KY 40508

Mailing address

138 Leader Ave
Room 9a
Lexington, KY 40508
Phone (304) 546-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20140925000302 WV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0941420947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BC 07274801978WVMDPediatrics Physician
50385KYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Wa Past Accepting new patients
Multicare Health System Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1861808271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE",
            "address_2": "ROOM 9A",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40508",
            "telephone_number": "304-546-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 LEADER AVE RM 9A",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40508",
            "telephone_number": "859-218-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "RUCHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "BC 07274801978",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "50385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.