RAKENDU PRAKASH SHUKLA (NPI# 1316387137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316387137 |
| Entity Type | Individual |
| Full Name | RAKENDU PRAKASH SHUKLA |
| Credential | MD |
| Practice Address |
148 Bill Carruth Pkwy Ste Ll30 Hiram GA 30141-3768 |
| Mailing Address |
148 Bill Carruth Parkway Suite Ll30 Hiram GA 30141 |
| Practice Telephone | 7705053855 |
| Practice Fax Number | 7704436654 |
| Mailing Telephone | 4706448140 |
| Mailing Fax Number | 7704436654 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
85977 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | OR | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 301413768 | 7705053855 | 7704436654 |
| Street Address |
148 BILL CARRUTH PKWY STE LL30 |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-3768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164841888 | Adam Ferro | Radiology | 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 30141-3768 | 2014-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164841888 | Adam Ferro | Radiology | 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 30141-3768 | 2014-04-09 |
| 1609039882 | Christine Min | Radiology | 148 Bill Carruth Pkwy, Suite Ll30, Hiram, GA 30141-3754 | 2008-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1962910679 | American Professional Associates LLC | Radiology | 33 Upper Riverdale Rd Sw Ste 105, Riverdale, GA 30274-2642 | 2018-01-16 |
| 1003324187 | American Professional Associates LLC | Radiology | 1136 Cleveland Ave Ste 119, East Point, GA 30344-3618 | 2018-01-11 |
| 1023301082 | Jolinta Lin | Radiology | The Emory Clinic Dept of Radiation Oncology, 1365 Clifton Road, Ne, Atlanta, GA 30322-0001 | 2011-05-25 |
| 1679739825 | Charles Reginald Woods IIi | Radiology | 275 Professional Ct, Suite B, Riverdale, GA 30274-2531 | 2008-08-06 |
| 1003086216 | Coastal Radiation Oncology Assoc. | Radiology | 2500 Starling St Ste 107, Brunswick, GA 31520-4266 | 2008-03-04 |
| 1275710899 | Shannon Tucker Kahn | Radiology | 639 Kimberly Ln Ne, Atlanta, GA 30306-2224 | 2008-01-25 |
| 1295924801 | Brian Wise Weaver | Radiology | 1355 Heatherland Dr Sw, Atlanta, GA 30331-7460 | 2007-10-19 |
| 1225245798 | John W Devine, Md, PC | Radiology | 209 Pendleton Dr, Valdosta, GA 31602-1729 | 2007-05-16 |
| 1356475131 | Winburn Jackson Dickens | Radiology | 152 Monroe Hwy, Winder, GA 30680-0664 | 2007-03-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.