Hetal Shah, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

58641 Issued in GA

Practice address

3535 Roswell Rd
Suite 54
Marietta, GA 30062-8826

Phone

(404) 943-1979

Fax

(678) 741-2140

NPI assigned

Aug 5, 2006

Last updated

Sep 14, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids Time Pediatrics - East Cobb LLC

  dba Kids Time Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Madison, GA
  • NPI 1184935223
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284422400000",
    "number": "1881603512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 MOUNT VERNON CIR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303385435",
            "telephone_number": "404-580-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ROSWELL RD",
            "address_2": "SUITE 54",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628826",
            "telephone_number": "404-943-1979",
            "fax_number": "678-741-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "HETAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "58641",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "36348",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "22224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don W Shaffer, MD
• Aashka Shah, MD
• Ashish Shah
• Dimple D. Shah, M.D.
• Erica R Shah, O.D.
• Jinen Shah, OD
• Kajal K Shah
• Kandarp Shah
• Leena Shah, PA
• Nikhil S Shah, M.D.

• Pediatrics Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; 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.