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1376985630 NPI number — NIKET SHAH D.O.

NPI Number: 1376985630
Health Care Provider/Practitioner: NIKET SHAH D.O.

Information about “1376985630” NPI (NIKET SHAH D.O.) exists in 1376985630 in HTML format HTML  |  1376985630 in plain Text format TXT  |  1376985630 in PDF (Portable Document Format) PDF  |  1376985630 in an XML format XML  formats.

NPI Number : 1376985630 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376985630",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHAH",
    "FirstName": "NIKET",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "933 W VAN BUREN ST APT 405",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60607-3582",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-379-7859",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "800 GARFIELD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PARKERSBURG",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "26101-5340",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "304-424-2111",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/26/2013",
    "LastUpdateDate": "10/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "02005005A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "ED0400A",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "02005005A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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