Shree Yamuna Maharaniji,PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038955 Issued in GA

Legal business name

SHREE YAMUNA MAHARANIJI,PC

Practice address

2615 E West Connector Ste 106
Austell, GA 30106-6848

Phone

(770) 941-0010

Fax

(770) 941-0154

NPI assigned

Aug 18, 2016

Organization subpart

No

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

Authorized official

Name

Chandresh B Shah, M.D.NPI 1770655987

Title

Owner

Phone

(770) 941-0010

Specialties & licenses 1

Addresses

Other names 1

• Cobb Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chandresh B. Shah, M.D.

  • Internal Medicine Physician
  • Austell, GA
  • NPI 1770655987
  Medicare reassignment Care Compare group NPD Authorized official
• Elman Otniel Gonzales Hernandez, PA

  • Medical Physician Assistant
  • Austell, GA
  • NPI 1770273385
  Medicare reassignment Care Compare group
• Vanessa Castro

  • Medical Physician Assistant
  • Austell, GA
  • NPI 1770215287
  Medicare reassignment
• Alina Guzman Camacho, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1467141267
  NPD
• Stacey Tsitsilianos, FNP-C, ENP-C

  • Family Nurse Practitioner
  • McDonough, GA
  • NPI 1437898434
  NPD
• Truc My Thi Dao, PA-C

  • Physician Assistant
  • Austell, GA
  • NPI 1619821394
  NPD (past)
• Joy Chidinma Ezuma

  • Nurse Practitioner
  • Austell, GA
  • NPI 1932601143
  NPD (past)

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1922553023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E WEST CONNECTOR STE 106",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066848",
            "telephone_number": "770-941-0010",
            "fax_number": "770-941-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E WEST CONNECTOR STE 106",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301066848",
            "telephone_number": "770-941-0010",
            "fax_number": "770-941-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREE YAMUNA MAHARANIJI,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "CHANDRESH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-941-0010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "038955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cobb Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cobb Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Lawson Shaw, MD
• Shelly Mixson
• Christine Andrews Shenk, PTA
• Breonna Jarraye Shepherd, PHARM.D.
• Afshin Shirinzadeh, D.C.
• Aseem Shrivastava, MD
• Paulomi Sahir Shroff, M.D.
• Yahya Khalid Siddiq, M.D.
• Henry Siegelson
• Harry Ellsworth Siegrist III, D.C, L.D.O.

• Clinic/Center in Austell, GA
• Providers in Austell, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.