Bavikatte N Shivakumar, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036063062 Issued in IL

Practice address

5041 Utica Ridge Rd
Suite 100
Davenport, IA 52807-3480

Phone

(563) 359-9696

Fax

(563) 359-1730

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mississippi Medical Plaza, LC

  • Ambulatory Surgical Clinic/Center
  • Davenport, IA
  • NPI 1619933835
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1043200835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5041 UTICA RIDGE RD",
            "address_2": "SUITE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073480",
            "telephone_number": "563-359-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5041 UTICA RIDGE RD",
            "address_2": "SUITE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073480",
            "telephone_number": "563-359-9696",
            "fax_number": "563-359-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAKUMAR",
        "first_name": "BAVIKATTE",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "22168",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036063062",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036063062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boyoung Shim, FNP-BC
• Jennifer Marie Shinners, LMSW
• Shipman Chiropractic
• Shipman Chiropractic PC
• Randall Eugene Shipman, D.C.
• Jiovanni N Shivers
• Rodney A Short, M.D.
• Cheryl Kay Shovlain, CADC
• Heather Marie Shuey, PMHNP-BC
• Abby Mariah Shumate, DNP, ARNP, AGACNP-BC

• Gastroenterology Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Gastroenterology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.