Bushra Shah MD PLLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

E-3672 Issued in AR

Legal business name

BUSHRA SHAH MD PLLC

Practice address

100 Vigne Dr
Little Rock, AR 72223-4581

Phone

(501) 552-4777

NPI assigned

Apr 12, 2017

Last updated

Apr 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bushra Shah, MDNPI 1417910670

Title

Owner

Phone

(501) 552-4777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bushra Shah, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
  • NPI 1417910670
  Medicare reassignment NPD Authorized official
• Rachel Dyan Golden, PA

  • Physician Assistant
  • Little Rock, AR
  • NPI 1457690414
  Medicare reassignment

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1992239479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VIGNE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234581",
            "telephone_number": "501-552-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VIGNE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234581",
            "telephone_number": "501-552-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHRA SHAH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BUSHRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-552-4777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E-3672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Bush
• Syreta Bush, RN
• Thomas James Bush Jr., D.D.S.
• Samantha Bushey
• Martha Kay Bushmiaer, APN
• Tatiana Buskirk
• Gelina Gabrielle Buslig, MD
• Aaron L. Bussard
• Alejandro Kristian Bustamante, MD
• Andre Lazaro Bustamante, APRN

• Geriatric Medicine (Internal Medicine) Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Geriatric Medicine (Internal Medicine) Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.