Ashwin Ballupet Shivakumar, MD. MS

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Practice address

611 W Park St
Forum LL
Urbana, IL 61801-2500

Phone

(217) 383-3110

NPI assigned

Mar 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1972773950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FORUM LL",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FORUM LL",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVAKUMAR",
        "first_name": "ASHWIN",
        "middle_name": "BALLUPET",
        "credential": "MD. MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Shepherd, LCSW
• Maulik B Sheth, M.D.
• Bart Randall Shields, CRNA
• Noemi L Shilts, NP
• Sara Shipley, CADC
• Edward Shlasko, M.D.
• Karima M Shmila, MD
• Brittney Shock, RN, CNM
• Casey D Shroyer, PA
• April Dawn Shubert

• Internal Medicine Physician in Urbana, IL
• Providers in Urbana, 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.