Individual provider Active NPI

Jane Shanthi Chikkala, MD

  • Pediatrics Physician
  • Toledo, OH
National Provider Identifier
1124104989
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.089043 Issued in OH
Practice address
3020 N McCord Rd Ste 100
Toledo, OH 43615-1701
Phone
(419) 517-7658
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.089043 OH Primary
Pediatrics Physician 208000000X 4301088975 MI

Addresses

Primary practice location

3020 N McCord Rd Ste 100
Toledo, OH 43615-1701

Mailing address

4126 N Holland Sylvania Rd Ste 220
Toledo, OH 43623-3537
Phone (419) 517-7600

Other identifiers 1

IdentifierTypeStateIssuer
2876213MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140603001183 OH Practitioner - Pediatric Medicine 7517101645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301088975MIMDPediatrics Physician
35.089043OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pediatric Specialists, LLC Pediatrics CurrentSince Mar 1, 2022 Accepting new patients

Locations

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

4126 N Holland Sylvania Rd
Ste 220
Toledo, OH 43623
Phone (419) 517-7600

3020 N McCord Rd
Ste 100
Toledo, OH 43615
Phone (419) 251-8013

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2229/brand/3/csg/621/fhir/r4
  • FHIR API: https://hkc.nationwidechildrens.org/FHIR/MYCHART/api/FHIR/R4
  • Direct secure messaging: jchikkala85855@direct.bsmhealth.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1124104989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 N HOLLAND SYLVANIA RD STE 220",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233537",
            "telephone_number": "419-517-7600",
            "fax_number": "419-517-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 N MCCORD RD STE 100",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151701",
            "telephone_number": "419-517-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIKKALA",
        "first_name": "JANE",
        "middle_name": "SHANTHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.089043",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301088975",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2876213",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.