Lata R Shukla, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01052377A Issued in IN

Practice address

7220 E Virginia St
Evansville, IN 47715-4068

Phone

(812) 473-8986

Fax

(812) 471-6692

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Pediatric Medicine

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lata.shukla.1@7598.direct.athenahealth.com

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.

• St Mary'S Medical Group, LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1164852539

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Primary Physicians Network LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1578786612

  Pediatrics

  NPD
• St Mary'S Medical Group, LLC

  • Nephrology Physician
  • Evansville, IN
  • NPI 1619307873
  NPD
• St. Mary'S Health, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1144269044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154068",
            "telephone_number": "812-473-8986",
            "fax_number": "812-471-6692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUKLA",
        "first_name": "LATA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01052377A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200319540",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lata.shukla.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "7220 E Virginia St",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477154068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mindy Sue Shoulders, NP
• Christopher C Shrack, DO
• Kadottie Miriam Shrader, LMHCA
• John Oslage Shrode, DDS
• Juhi Shukla, PT, MHS
• Tabitha A Shults, NP
• Rachel Leigh Shultz
• Paul F Siami, MD
• Sicc Services LLC
• Amy Siddens Land, MSW, LCSW

• Pediatrics Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.