DR. SHAZIA SHIVJI (NPI# 1639681018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639681018 |
| Entity Type | Individual |
| Full Name | DR. SHAZIA SHIVJI |
| Credential | MD |
| Practice Address |
6200 Central Ave Portage IN 46368-3702 |
| Mailing Address |
2022 Kelle Dr Chesterton IN 46304-8708 |
| Practice Telephone | 2197621040 |
| Practice Fax Number | 2197621041 |
| Mailing Telephone | 2193643616 |
| Mailing Fax Number | 2193643610 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2020-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01084682A | IN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 125.071584 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5145 N California Ave, Chicago, IL 606253661 | 7738788200 |
| Street Address |
6200 CENTRAL AVE |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851812572 | Shaun Sadruddin Mehdi | Internal Medicine | 6200 Central Ave, Portage, IN 46368-3702 | 2017-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1821278193 | Primary Care Clinic of Jackson, P.C. | Internal Medicine | 2218 Sugarloaf Ave, Portage, MI 49024-6771 | 2007-11-05 |
| 1689868697 | Kevin J. Kelly Md, PC | Internal Medicine | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2007-09-02 |
| 1548464035 | Amanda Rose Henry | Internal Medicine | 245 W Centre Ave, Portage, MI 49024-5331 | 2007-06-11 |
| 1245263623 | Shirani Damayanthi Wijay-samarasinha | Internal Medicine | 5829 S Westnedge Ave, Portage, MI 49002-1456 | 2006-07-08 |
| 1710942479 | Kevin James Kelly | Internal Medicine | 8145 Valleywood Ln, Suite B, Portage, MI 49024-5296 | 2006-04-18 |
| 1740267947 | Robert M. Soltysiak | Internal Medicine | 917 W. Milham Ave, Portage, MI 49024 | 2005-12-28 |
| 1972586592 | Maureen Onuigbo | Internal Medicine | 2725 Airview Blvd, Ste 105, Portage, MI 49002-1803 | 2005-11-29 |
| 1821099219 | Simon Hoogendyk | Internal Medicine | 401 W Kilgore Rd, Portage, MI 49002-1100 | 2005-08-09 |
| 1851812572 | Shaun Sadruddin Mehdi | Internal Medicine | 6200 Central Ave, Portage, IN 46368-3702 | 2017-07-03 |
| 1841663754 | Inpatient Physician Group LLC | Internal Medicine | 3156 Willowcreek Rd, Portage, IN 46368-4424 | 2015-11-02 |
| Find all providers in PORTAGE | ||||
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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.