Sudhakar Krishnadas Sheth, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036059241 Issued in IL

Practice address

2 Memorial Drive
Suite 101
Decatur, IL 62526-1589

Phone

(217) 875-2640

Fax

(217) 875-3101

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1699707679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DRIVE",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261589",
            "telephone_number": "217-875-2640",
            "fax_number": "217-875-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DRIVE",
            "address_2": "SUITE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261589",
            "telephone_number": "217-875-2640",
            "fax_number": "217-875-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETH",
        "first_name": "SUDHAKAR",
        "middle_name": "KRISHNADAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036059241",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036059241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059241",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Edward Sheary, OD
• Sheila J Woodrow PC
• Nathan Taylor Shelsta, ATC
• Jordan Sheraden
• Scott E Sherwood, M.D.
• Lindsay Shiflett
• Amanda C Shils, P.A.
• Philippe N Shils, PA
• Meghann Shipley
• Zachary James Shipp, M.D.

• Gastroenterology Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.