Shantha Matthew Monippallil, M.D

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

036058112 Issued in IL

Practice address

1901 S 4TH St
Same
Effingham, IL 62401-4187

Phone

(217) 347-7600

NPI assigned

Aug 11, 2005

Last updated

Jul 17, 2007By 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 names 1

• Dr. Shantha Matthew Monippallil Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1437151271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S 4TH ST",
            "address_2": "SAME",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014187",
            "telephone_number": "217-347-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 4TH ST",
            "address_2": "SAME",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014187",
            "telephone_number": "217-347-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIPPALLIL",
        "first_name": "SHANTHA",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036058112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTHA",
            "last_name": "MONIPPALLIL",
            "middle_name": "MATTHEW",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bobbie J. Miller, PA-C
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• Martha T Mioux, PT
• Mommy & Me Boutique, Inc.
• Amalio Montez
• Regan Moomaw, DPT
• Diana Lynn Moon, MS, LPC
• Moore Family Stores Inc. (Browns Drug Store)
• Scott Moore, DMD

• Adult Medicine Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Adult Medicine Physician in Illinois

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