Jinesh Shah, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

ML60568908 Issued in WA

Practice address

780 Swift Blvd
Kadlec Family Medicine Residency
Richland, WA 99352-3524

Phone

(509) 942-2516

Fax

(509) 942-3218

NPI assigned

Apr 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1972999142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SWIFT BLVD",
            "address_2": "KADLEC FAMILY MEDICINE RESIDENCY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523524",
            "telephone_number": "509-942-2516",
            "fax_number": "509-942-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SWIFT BLVD",
            "address_2": "KADLEC FAMILY MEDICINE RESIDENCY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523524",
            "telephone_number": "509-942-2516",
            "fax_number": "509-942-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JINESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "ML60568908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972999142",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noelle Maree Sernett, ATC
• Katie Lynn Seward, LBA, BCBA
• Shatabdi Shabnam, MD
• Annaliese Shafer, COTA
• Christine Shaffer, M.S. CCC-SLP
• Rohan S. Shah, DO
• Marisa Shane
• Haley Anne Shannon, ARNP
• Jillian Leigh Shannon
• Steven Shao, DO

• Student in an Organized Health Care Education/Training Program in Richland, WA
• Providers in Richland, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.