Active NPI
Shobha U Lall, MD
- Pediatrics Physician
- Cambridge, OH
National Provider Identifier
1407882806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35039646
- Practice address
- 1432 Clark St
Suite 5
Cambridge, OH 43725-8745 - Phone
- (740) 439-6664
- Fax
- (740) 439-8664
- NPI assigned
- Jun 25, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35039646 | OH | Primary |
Addresses
Primary practice location
1432 Clark St
Suite 5
Cambridge, OH 43725-8745
Mailing address
1432 Clark St
Suite 5
Cambridge, OH 43725-8745
Phone (740) 439-6664
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0310685 | Medicaid | OH | |
| C0039646 | Other | OH | HEALTH PLAN OF UPPER OHIO |
| 1200270 | Other | OH | UNITED HEALTH PLAN |
| 44440 | Other | OH | CORE SOURCE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35039646 | OH | MD | Pediatrics 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.
-
- Pediatrics Physician
- Cambridge, OH
- NPI 1457870313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407882806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1432 CLARK ST",
"address_2": "SUITE 5",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437258745",
"telephone_number": "740-439-6664",
"fax_number": "740-439-8664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 CLARK ST",
"address_2": "SUITE 5",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437258745",
"telephone_number": "740-439-6664",
"fax_number": "740-439-8664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALL",
"first_name": "SHOBHA",
"middle_name": "U",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35039646",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0310685",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF UPPER OHIO",
"identifier": "C0039646",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH PLAN",
"identifier": "1200270",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORE SOURCE",
"identifier": "44440",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.