Shobha Shakamuri, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

G8756 Issued in TX

Practice address

3535 N Fourth St Ste 301
Longview, TX 75605-0037

Phone

(903) 234-9992

Fax

(903) 234-8287

NPI assigned

Apr 18, 2006

Last updated

Oct 6, 2021By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nephrology

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Kidney Specialists,PAGroup PAC ID 6901856806, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Longview Dialysis Center Dialysis facility, Longview, TX, CCN 452744
• Longview Regional Medical Center Hospital, Longview, TX, CCN 450702
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Texas Kidney Specialists,PA

  dba East Texas Kidney Specialists

  • Nephrology Physician
  • Longview, TX
  • NPI 1184689622
  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Renal Treatment Centers-Southeast, LP.

  dba Longview Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Longview, TX
  • NPI 1316900137

  Dialysis facility

  Care Compare affiliation Name & address match
• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Longview Medical Center LP

  dba Longview Regional Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1528026267
  Care Compare affiliation

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1902861446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 301",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050037",
            "telephone_number": "903-234-9992",
            "fax_number": "903-234-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N FOURTH ST STE 301",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756050037",
            "telephone_number": "903-234-9992",
            "fax_number": "903-234-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAKAMURI",
        "first_name": "SHOBHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "G8756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL",
            "identifier": "752896100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "8B0770",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serve All Medical Longview, PLLC (Clinica Hispana)
• Jerry Serville, CRNA
• Jeffrey William Sewell, MD
• Ryan Hansen Sexton, CRNA
• Shacklefree Ministries
• Khamis A Shalabi, MD
• Neeraj Roshanial Sharma, MD
• Bert Eagle Sharp, D.P.M.
• Debbie Lynette Sharp, RPH
• Carrie Beth Shaw, LPC

• Nephrology Physician in Longview, TX
• Providers in Longview, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.