PAVANI THOTAKURA SHAH M.D. NPI 1689920464

NPI Information

NPI: 1689920464
Provider Name: PAVANI THOTAKURA SHAH, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: PRISMA HEALTH UNIVERSITY MEDICAL GROUP

PECOS Registration: Yes

Address:
1210 W FARIS RD
GREENVILLE, SC
ZIP 29605
Phone: (864) 522-1800
Get Directions

Pavani Thotakura Shah, M.D. is a diagnostic radiology radiology in Greenville, SC with 12 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Pavani Thotakura Shah, M.D. NPI is 1689920464. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1210 W FARIS RD
GREENVILLE, SC
ZIP 29605-444
Phone: (864) 522-1800
Fax: (864) 522-1806

The NPI 1689920464 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2012 and was last updated on 5/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	2017-01250	NORTH CAROLINA	No
2	207R00000X	Internal Medicine		125.060992	ILLINOIS	No
3	2085R0202X	Radiology	Diagnostic Radiology	82380	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10118Q	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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