Douglas Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

019103 Issued in GA

Legal business name

DOUGLAS MEDICAL GROUP

Practice address

6025 Professional Pkwy
Suite 200
Douglasville, GA 30134-5609

Phone

(770) 949-0555

Fax

(770) 949-4424

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Girish I Shroff, MD

Title

President

Phone

(770) 949-0555

Specialties & licenses 5

Addresses

Other identifiers 4

Other names 1

• Shroff and Desai M D , P C Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chandresh B. Shah, M.D.

  • Internal Medicine Physician
  • Austell, GA
  • NPI 1770655987
  NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1992929186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY",
            "address_2": "SUITE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345609",
            "telephone_number": "770-949-0555",
            "fax_number": "770-949-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "SHROFF",
        "authorized_official_first_name": "GIRISH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-949-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "019103",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "027530",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "061515",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN167533",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN095208",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00305302B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452595412D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000137827B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002528159A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shroff and Desai M D , P C",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Douglas County School System
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• Douglas Hospital, Inc.
• Douglas Medical Group
• Douglas Neurology Associates, P.C.
• Douglas Pediatrics Associates Inc. P.C.
• Douglasville Adent, LLC
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• Internal Medicine Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.