DR SHRESTHA MD SC (NPI# 1699045740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699045740 |
| Entity Type | Organization |
| Organization Name | DR SHRESTHA MD SC |
| Practice Address |
1050 M L King Dr Suite 111 Centralia IL 62801-3060 |
| Mailing Address |
605 Sable Dr Centralia IL 62801-4472 |
| Practice Telephone | 5678684507 |
| Practice Fax Number | 8773977287 |
| Mailing Telephone | 5678684507 |
| Mailing Fax Number | 8773957287 |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |
| Authorized Official Name | DR. NIRANJAN SHRESTHA (PRESIDENT) |
| Authorized Official Telephone | 5678684507 |
| Authorized Official Credential | MD, FAAFP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | IL | Ambulatory Health Care Facilities |
| Street Address |
1050 M L KING DR SUITE 111 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681700 | Elizabeth Franczyk | Specialist | 1050 M L King Dr, Suite 102, Centralia, IL 62801-3060 | 2005-07-05 |
| 1114120177 | Kamran Amir Khan | Hospitalist | 1050 M L King Dr, Suite 109, Centralia, IL 62801-3060 | 2007-06-07 |
| 1790810216 | Naeem A Khan Md Sc | Internal Medicine | 1050 M L King Dr, Suite 108, Centralia, IL 62801-3060 | 2007-02-23 |
| 1275540015 | Aziz U Rahman | Internal Medicine | 1050 M L King Dr, Suite 109, Centralia, IL 62801-3060 | 2006-08-02 |
| 1245259274 | Rajendra R Shroff | Internal Medicine | 1050 M L King Dr, Suite 101, Centralia, IL 62801-3060 | 2006-07-19 |
| 1801888276 | Tom D Martin | Internal Medicine | 1050 M L King Dr, Suite 104, Centralia, IL 62801-3060 | 2005-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124117197 | Providence Health & Service Washington | Clinic/Center | 1010 South Scheuber Rd, Suites 3 & 4, Centralia, WA 98531-8892 | 2006-10-11 |
| 1598254617 | Absolute Health International Inc | Clinic/Center | 2020 Borst Ave, Centralia, WA 98531-1404 | 2018-05-03 |
| 1790037224 | Star Medical Clinic Inc. | Clinic/Center | 1217 Mellen St, Centralia, WA 98531-1175 | 2012-10-08 |
| 1932397510 | My Urban Clinic, Inc | Clinic/Center | 817 E Mccord, Centralia, IL 62801 | 2007-10-09 |
| 1689873937 | Providence Health & Services Washington | Clinic/Center | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2007-07-17 |
| 1265495824 | Ambulatory Surgery Center of Centralia, LLC | Clinic/Center | 1045 Martin Luther King Dr, Centralia, IL 62801-3001 | 2006-04-06 |
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| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
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| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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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.