Individual provider Active NPI

Mamun Shahrier, MD, PHD

  • Gastroenterology Physician
  • Louisburg, NC
National Provider Identifier
1881685428
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Practice address
626 N Bickett Blvd
Louisburg, NC 27549-2314
Phone
(919) 496-2745
Fax
(919) 496-3888
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NC Primary

Addresses

Primary practice location

626 N Bickett Blvd
Louisburg, NC 27549-2314

Mailing address

626 N Bickett Blvd
Louisburg, NC 27549-2314
Phone (919) 496-2745

Other identifiers 3

IdentifierTypeStateIssuer
89134JUMedicaidNC
P00055459OtherNCRAILROAD MEDICARE
134JUOtherNCBCBS NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20071129000358 NC Practitioner - Gastroenterology 3779672647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Charles Rollins Rd
Suite 201
Henderson, NC 27536-2882
Phone (252) 430-8111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy113
Upper gastrointestinal (GI) endoscopy for acid reflux95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
200300880NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices LLC CurrentSince Sep 14, 2020 Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Sep 14, 2020 Accepting new patients
DLP Wilson Physician Practices LLC CurrentSince Dec 1, 2015 Accepting new patients
DLP Wilson Physician Practices LLC Gastroenterology CurrentSince Dec 1, 2015 Accepting new patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

120 Charles Rollins Rd
Ste 201
Henderson, NC 27536
Phone (252) 430-8111

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

205 Sandalwood Ave
Ste B
Louisburg, NC 27549
Phone (919) 340-7010

2605 Forest Hills Rd SW
Ste A
Wilson, NC 27893
Phone (252) 243-0043

1700 Tarboro St W
Ste 205
Wilson, NC 27893
Phone (252) 399-5304

Interoperability endpoints

  • Direct secure messaging: mamum.shahrier.1@9600.direct.athenahealth.com
  • Direct secure messaging: mamunshahrier@ghcpa.allscriptsdirect.net
  • Direct secure messaging: mamun.shahrier.1@20247.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1881685428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N BICKETT BLVD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492314",
            "telephone_number": "919-496-2745",
            "fax_number": "919-496-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N BICKETT BLVD",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492314",
            "telephone_number": "919-496-2745",
            "fax_number": "919-496-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHRIER",
        "first_name": "MAMUN",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134JU",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00055459",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "134JU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

Verify at the official NPI Registry.