Active NPI
Freny Shah, M.D.
- Internal Medicine Physician
- Stone Mountain, GA
National Provider Identifier
1942592787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 88967
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241218002882 | GA | Practitioner - Internal Medicine | 1951610864 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Griffin Myers Medical, P.C. | Internal Medicine | Current | Accepting new patients |
| Qcpi-Villagemd, PC | Internal Medicine | Past | 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.
-
- Primary Care Clinic/Center
- Brooklyn, NY
- NPI 1780209445
Internal Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.