Individual provider Active NPI

Shanmugam Lakshmanan, MD

  • Surgery Physician
  • Salem, IL
National Provider Identifier
1356522718
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
111 E Rogers St
Salem, IL 62881-2902
Phone
(618) 548-5061
Fax
(618) 548-5079
NPI assigned
Nov 14, 2007
Last updated
Nov 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

111 E Rogers St
Salem, IL 62881-2902

Mailing address

111 E Rogers St
Salem, IL 62881-2902
Phone (618) 548-5061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-051027ILMDSurgery Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1356522718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E ROGERS ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812902",
            "telephone_number": "618-548-5061",
            "fax_number": "618-548-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E ROGERS ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812902",
            "telephone_number": "618-548-5061",
            "fax_number": "618-548-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKSHMANAN",
        "first_name": "SHANMUGAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; 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.