Individual provider Active NPI

Freny Shah, M.D.

  • Internal Medicine Physician
  • Stone Mountain, GA
National Provider Identifier
1942592787
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
88967 Issued in GA
Practice address
1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306
Phone
(470) 444-3134
Fax
(470) 276-4370
NPI assigned
May 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 280129 NY
Internal Medicine Physician 207R00000X 88967 GA Primary

Addresses

Primary practice location

1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Other practice location 1

800 Poly Pl
Department of Internal Medicine
Brooklyn, NY 11209-7104
Phone (718) 836-6600 ext. 3766

Other practice location 2

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241218002882 GA Practitioner - Internal Medicine 1951610864

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Myers Medical, P.C. Internal Medicine CurrentSince Oct 21, 2025 Accepting new patients
Qcpi-Villagemd, PC Internal Medicine PastSince Aug 8, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1942592787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 ROCKBRIDGE RD STE 15B",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873306",
            "telephone_number": "470-444-3134",
            "fax_number": "470-276-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Poly Pl",
            "address_2": "Department of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097104",
            "country_code": "US",
            "telephone_number": "718-836-6600 x3766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1670 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "FRENY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "280129",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "88967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.