| Shah And Associates Family Practice | |
|
431 Keisler Dr Ste 100 Cary NC 27518-7064 | |
| (919) 468-6820 | |
| (919) 468-6484 |
| Full Name | Shah And Associates Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 431 Keisler Dr Ste 100, Cary, North Carolina |
| Authorized Official Name and Position | Dipen R. Shah (PRESIDENT) |
| Authorized Official Contact | 9194686820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shah And Associates Family Practice 431 Keisler Dr Ste 100 Cary NC 27518-7064 Ph: (919) 468-6820 | Shah And Associates Family Practice 431 Keisler Dr Ste 100 Cary NC 27518-7064 Ph: (919) 468-6820 |
| NPI Number | 1093737173 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 12/27/2019 |
| Medicare PECOS PAC ID | 2365419967 |
|---|---|
| Medicare Enrollment ID | O20040914000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093737173 | NPI | - | NPPES |
| 89126ET | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | 200000306 (North Carolina) | Secondary |
| Provider Name | Dipen R Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750333993 PECOS PAC ID: 2264426741 Enrollment ID: I20050712000242 |
| Provider Name | Jennifer C Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255438081 PECOS PAC ID: 2062412612 Enrollment ID: I20070104000034 |
| Provider Name | Mary Beth Lipscomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932866407 PECOS PAC ID: 9133514797 Enrollment ID: I20220317000151 |
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