Active NPI
Sumati B. Shah, MD
- Family Medicine Physician
- Winston Salem, NC
National Provider Identifier
1972530368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 22664
- Practice address
- 3318 Healy Dr
Winston Salem, NC 27103-1404 - Phone
- (336) 768-3530
- Fax
- (336) 768-1329
- NPI assigned
- Jun 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22664 | NC | Primary |
Addresses
Primary practice location
3318 Healy Dr
Winston Salem, NC 27103-1404
Mailing address
3318 Healy Drive
Winston Salem, NC 27103-1404
Phone (336) 768-3530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22664 | NC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286841600000",
"number": "1972530368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3318 HEALY DRIVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031404",
"telephone_number": "336-768-3530",
"fax_number": "336-768-1329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3318 HEALY DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271031404",
"telephone_number": "336-768-3530",
"fax_number": "336-768-1329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "SUMATI",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2010-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "22664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.