| Foothills Consulting Associates Llc | |
|
615 S Dekalb St Shelby NC 28150-6184 | |
| (704) 480-1882 | |
| (704) 480-1832 |
| Full Name | Foothills Consulting Associates Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 615 S Dekalb St, Shelby, North Carolina |
| Authorized Official Name and Position | Nilima Daftary Shukla (PHYSICIAN) |
| Authorized Official Contact | 7044801882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothills Consulting Associates Llc Po Box 1418 Shelby NC 28151-1418 Ph: (704) 480-1882 | Foothills Consulting Associates Llc 615 S Dekalb St Shelby NC 28150-6184 Ph: (704) 480-1882 |
| NPI Number | 1770624637 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 03/30/2019 |
| Medicare PECOS PAC ID | 4688765589 |
|---|---|
| Medicare Enrollment ID | O20070808000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770624637 | NPI | - | NPPES |
| 89014RP | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 20933553 (North Carolina) | Primary |
| Provider Name | Nilima V Shukla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922189877 PECOS PAC ID: 2961505003 Enrollment ID: I20070906000770 |
| Provider Name | George L Bradley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033197645 PECOS PAC ID: 9436299435 Enrollment ID: I20091223000446 |
| Provider Name | Salema Coaxum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487021911 PECOS PAC ID: 4082956537 Enrollment ID: I20190502000454 |
| Provider Name | Carole Jean Jolley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932982006 PECOS PAC ID: 4385099548 Enrollment ID: I20231009003006 |
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