DR. PUNITHA SHIVAPRASAD (NPI# 1609111699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609111699 |
| Entity Type | Individual |
| Full Name | DR. PUNITHA SHIVAPRASAD |
| Credential | D.O |
| Practice Address |
601 Route 73 N Ste 101 Marlton NJ 08053-3472 |
| Mailing Address |
301 Lippincott Dr Ste 410 Marlton NJ 08053-4197 |
| Practice Telephone | 8562378045 |
| Practice Fax Number | 8562378047 |
| Mailing Telephone | 8563550340 |
| Mailing Fax Number | 8563550330 |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
25MB09222600 | NJ | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036.145264 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | HORIZON | 1609111699 | 01 |
| NJ | AETNA | 1609111699 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2601 W Main St, Carbondale, IL 629011031 | 6183517300 | 6184577890 |
| 404 Lincoln Dr, Herrin, IL 62948 | 6189930056 | 6189930752 |
| Street Address |
601 ROUTE 73 N STE 101 |
| City | MARLTON |
| State | NJ |
| Zip Code | 08053-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750544391 | Theresa Maria Disandro | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2008-07-03 |
| 1578022687 | Sharon Ruth Everett | Nurse Practitioner | 601 Route 73 N Ste 101, Marlton, NJ 08053 | 2019-03-18 |
| 1477064046 | Merrill Turner | Physician Assistant | 601 Route 73 N Ste 101, Marlton, NJ 08053 | 2017-10-23 |
| 1427569045 | Elias Demetrios Poulos | Physician Assistant | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2017-10-23 |
| 1700221603 | Daniel Ryan Brandt | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2013-05-06 |
| 1497098537 | Jessica Ann Briscoe | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2013-03-27 |
| 1699017848 | Krysta Johns-keating | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2013-03-25 |
| 1760724504 | Charles A Snyder | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053 | 2013-03-19 |
| 1710260724 | Sarah Ann Amato | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2011-09-26 |
| 1912285255 | Tarun A Patel | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053 | 2011-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619509288 | South Jersey Coping Clinic | Counselor | 525 Nj Route 73 South, Ste 306, Marlton, NJ 08053 | 2020-02-11 |
| 1780216952 | Aba Residential | Psychologist | 7 Cooper Ave Suit A, Marlton, NJ 08053 | 2020-02-06 |
| 1003447400 | Forrest Mark Waterman | Optometrist | 928 Nj-73, Evesham Township, NJ 08053 | 2020-02-04 |
| 1124666862 | Bh Brightview Greentree Opco, LLC | Alzheimer Center (Dementia Center) | 170 Grrentree Road, Marlton, NJ 08053 | 2019-12-12 |
| 1780226597 | Cassandra Ann Pistorius | Counselor | 77 Lakeside Dr, Marlton, NJ 08053 | 2019-10-14 |
| 1265099741 | Jessica Strassle | Occupational Therapist | 751 Nj-73, Suite 1, Marlton, NJ 08053 | 2019-05-21 |
| 1972169902 | Jefferson University Radiology Associates, LLC | Radiology | 999 Nj-73, # 101, Marlton, NJ 08053 | 2019-05-15 |
| 1235692120 | Liberty Corner Surgical Center At Marlton LLC | Clinic/Center | 95 Marlton Pike West, Marlton, NJ 08053 | 2019-04-09 |
| 1063995769 | Genesis Counseling Center, Inc. | Counselor | 2003 C Lincoln Dr. W., Marlton, NJ 08053 | 2018-09-10 |
| 1659853414 | Erika V Colbert | Nurse Practitioner | 1 Eves Drive 134, 134, Marlton, NJ 08053 | 2018-08-29 |
| Find all providers in zip 08053 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306372578 | Advocare Allied Gastrointestinal Associates | Internal Medicine | 401 Route 73 N, Bldg 10, Ste 320, Lake Center Executive Park, Marlton, NJ 08053 | 2017-05-10 |
| 1750544391 | Theresa Maria Disandro | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2008-07-03 |
| 1144433673 | Stacey Rene Zavala | Internal Medicine | 406 Lippincott Dr Ste E, Marlton, NJ 08053-4168 | 2007-05-08 |
| 1588624340 | Jack J Devita | Internal Medicine | 406 Lippincott Dr., Suite E, Marlton, NJ 08053 | 2006-03-24 |
| 1295713212 | Steven Liakos | Internal Medicine | 406 Lippincott Dr, Suite E, Marlton, NJ 08053-4168 | 2006-01-09 |
| 1568440592 | Gary H. Levin | Internal Medicine | 406 Lippincott Drive, Suite E, Marlton, NJ 08053-4168 | 2006-01-09 |
| 1992793590 | Jeffrey Jay Sorokin | Internal Medicine | 100 Brick Rd, Suite 216, Marlton, NJ 08053-2146 | 2005-10-09 |
| 1700221603 | Daniel Ryan Brandt | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2013-05-06 |
| 1699017848 | Krysta Johns-keating | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053-3472 | 2013-03-25 |
| 1760724504 | Charles A Snyder | Internal Medicine | 601 Route 73 N Ste 101, Marlton, NJ 08053 | 2013-03-19 |
| Find all providers in MARLTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.