Rajendra R Shroff MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

RAJENDRA R SHROFF MD SC

Practice address

1050 M L King Dr Ste 101
Centralia, IL 62801-3060

Phone

(618) 532-5700

Fax

(618) 532-7390

NPI assigned

Mar 6, 2008

Last updated

Mar 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Brenda Sue Lance

Title

Office Manager

Phone

(618) 532-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Rajendra R Shroff MD SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rajendra R Shroff MD SC

  • Internal Medicine Physician
  • Centralia, IL
  • NPI 1417203670
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rajendra R Shroff, M.D.

  • Internal Medicine Physician
  • Centralia, IL
  • NPI 1245259274
  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1831369735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 M L KING DR STE 101",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013060",
            "telephone_number": "618-532-5700",
            "fax_number": "618-532-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 M L KING DR STE 101",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013060",
            "telephone_number": "618-532-5700",
            "fax_number": "618-532-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJENDRA R SHROFF MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "LANCE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "618-532-5700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0006100111",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Beth Purcell, RN, BSN, OCN, MBA
• Raccoon C S D 1
• William Thomas Radcliffe
• Aziz U Rahman, MD
• Rajendra R Shroff MD SC
• Ruth E Rakey, APN
• Danielle Ranes
• Krista Ratermann, PT
• Whitney Rathmann
• Sharon Reed, LCPC

• Internal Medicine Physician in Centralia, IL
• Providers in Centralia, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.