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Shari K Rajoo

Family Medicine

Allopathic & Osteopathic Physicians

2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4657

PECOS Enrollment

This provider is enrolled in PECOS as SHARI RAJOO.

Based on the most recent information from CMS, provider Shari K Rajoo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 4:18 PM.

Profile Details

Provider ID
1730149790
Provider Type
Individual
Full Name
Rajoo, Shari K
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
3/24/2006
Last Updated
2/22/2017

Contact Information

Practice Location

2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4657

(423) 224-3900

(423) 224-3901

Mailing Location

2204 Pavilion Dr, Suite 310, Kingsport, TN 37660-4657

(423) 224-3900

(423) 224-3901

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 42149 Tennessee
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 233784 New York

Provider Identifiers

ID	Description	Issuer
ID 1505112	Description Medicaid	Issuer Unlisted Tennessee
ID 1730149790	Description Medicaid	Issuer Unlisted Virginia

Shari K Rajoo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Jones, Lesley Ann

Hager, Shelton

Akins, Megan Teresa

Geer, Robert

Bockhorst, Peter R

Sumpter, Zachary Linuel

Vaughn, Jeffrey

Bates, Chad

Windes, Lois