Active NPI
Shiv Suman Kapoor, M.D.
- Internal Medicine Physician
- Liberty Township, OH
National Provider Identifier
1982785309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35.132511
- Practice address
- 4652 Partners Place
Liberty Township, OH 45011 - Phone
- (513) 603-8720
- Fax
- (513) 603-8739
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01042317 | IN | |
| Internal Medicine Physician | 207R00000X | 35.132511 | OH | Primary |
Addresses
Primary practice location
4652 Partners Place
Liberty Township, OH 45011
Mailing address
4652 Partners Place
Liberty Township, OH 45011
Phone (513) 603-8720
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100388470B | Medicaid | IN | |
| 0363454 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01042317 | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
Interoperability endpoints
- skapoor657265@direct.bsmhealth.org
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1982785309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4652 PARTNERS PLACE",
"city": "LIBERTY TOWNSHIP",
"state": "OH",
"postal_code": "45011",
"telephone_number": "513-603-8720",
"fax_number": "513-603-8739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4652 PARTNERS PLACE",
"city": "LIBERTY TOWNSHIP",
"state": "OH",
"postal_code": "45011",
"telephone_number": "513-603-8720",
"fax_number": "513-603-8739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAPOOR",
"first_name": "SHIV",
"middle_name": "SUMAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01042317",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.132511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100388470B",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0363454",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Liberty Township, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.