Shashanka Nethi, M.B.B.S.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01085108A Issued in IN

Practice address

811 W 2ND St
Bloomington, IN 47403-2212

Phone

(812) 333-4001

Fax

(812) 333-4057

NPI assigned

Apr 23, 2018

Last updated

Oct 4, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1285121574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 E RAYMOND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462034744",
            "telephone_number": "317-957-2000",
            "fax_number": "317-957-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032212",
            "telephone_number": "812-333-4001",
            "fax_number": "812-333-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETHI",
        "first_name": "SHASHANKA",
        "credential": "M.B.B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01085108A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300052974",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Nelson, M.D.
• Kimberly A Nelson, NP
• Nancy L Nelson, AU.D., CCC-A
• Taylor Nelson
• Stephen Nering, LMT
• Skyler Neuhaus, LSW
• Neurology Specialists, PC
• Neurosurgical Clinic of Bloomington Inc P.C.
• Jessica Nevitt, M.S., CHES
• New Beacon Hospice Indiana, LLC (New Beacon Bloomington)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.