Vipinchandra K Shah

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036053494 Issued in IL

Practice address

26 Camelot Dr
Edwardsville, IL 62025-3701

Phone

(618) 692-4373

NPI assigned

Jul 24, 2006

Last updated

Jun 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394
  Medicare reassignment NPD
• Illinois Department of Human Services

  • Psychiatric Hospital
  • Chester, IL
  • NPI 1306834726
  NPD
• Illinois Department of Human Services

  dba John J Madden Mental Health

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD
• Illinois Department of Human

  dba Shapiro Developmental Center Pharmacy

  • Long Term Care Pharmacy
  • Kankakee, IL
  • NPI 1528111424
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1265454995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CAMELOT DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CAMELOT DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253701",
            "telephone_number": "618-692-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "VIPINCHANDRA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036053494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Grace Sebok, CD, CLC, SBD
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• Madison Nichole Sell, RN, SRNA
• Lindsay Serrano, LCPC
• Chairo Shaffer, COTA/L
• Taylor Paris Sharp, RN, BSN
• Shawnee Behavioral Consultation LLC
• Gabriela Shea
• Brian Shin, DDS
• Signature Endodontics

• General Practice Physician in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.