Individual provider Active NPI

Rakesh Kumar Shah, MD

  • Child & Adolescent Psychiatry Physician
  • Hopewell, VA
National Provider Identifier
1942419692
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
0101248223 Issued in VA
Practice address
207 N 4TH Ave
Hopewell, VA 23860-2503
Phone
(804) 541-0918
Fax
(804) 541-7924
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 0101248223 VA Primary
Psychiatry Physician 2084P0800X 0101248223 VA

Addresses

Primary practice location

207 N 4TH Ave
Hopewell, VA 23860-2503

Mailing address

269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone (804) 861-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20110511000075 VA Practitioner - Psychiatry 5294911137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Virginia South Psychiatric and Family ServicesGroup PAC ID 3476443797, 35 clinicians

Practice addresses (Care Compare)

13901 Coalfield Commons PL
Suite 102
Midlothian, VA 23114-1219
Phone (804) 378-0800

207 N 4TH Ave
Hopewell, VA 23860-2503
Phone (804) 518-6513

269 Medical Park Blvd
Petersburg, VA 23805-9337
Phone (804) 861-0700

Hospital & facility affiliations

  • John Randolph Medical Center Hospital, Hopewell, VA, CCN 490020
  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101248223VAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia South Psychiatric & Family Services Psychiatry CurrentSince Mar 11, 2011 Accepting new patients
Three Rivers Treatment Center LLC Past Accepting new patients

Locations

207 N 4th Ave
Hopewell, VA 23860
Phone (804) 518-6513

13901 Coalfield Commons Pl
Ste 102
Midlothian, VA 23114
Phone (804) 378-0800

269 Medical Park Blvd
Petersburg, VA 23805
Phone (804) 861-0700

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72142

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.

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1942419692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059337",
            "telephone_number": "804-861-0700",
            "fax_number": "804-863-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N 4TH AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238602503",
            "telephone_number": "804-541-0918",
            "fax_number": "804-541-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAKESH",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101248223",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101248223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell, VA

Sources for this page

Verify at the official NPI Registry.