Individual provider Active NPI

Kishori Piyush Shah, MD

  • Gynecology Physician
  • Huntington, IN
National Provider Identifier
1972567147
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
01026610A Issued in IN
Practice address
2814 Theater Ave
Huntington, IN 46750-7978
Phone
(260) 356-3611
Fax
(260) 358-4263
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 01026610A IN Primary

Addresses

Primary practice location

2814 Theater Ave
Huntington, IN 46750-7978

Mailing address

2814 Theater Ave
Huntington, IN 46750-7978
Phone (260) 356-3611

Other identifiers 1

IdentifierTypeStateIssuer
100467980BMedicaidIN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01026610AINMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Medical Specialists Gynecology PastSince Jul 7, 1980 Accepting new patients

Organizations & group practices 1

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1972567147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 THEATER AVE",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467507978",
            "telephone_number": "260-356-3611",
            "fax_number": "260-358-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 THEATER AVE",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467507978",
            "telephone_number": "260-356-3611",
            "fax_number": "260-358-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KISHORI",
        "middle_name": "PIYUSH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IN",
            "license": "01026610A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100467980B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.