DR. SHOBA THEIVANAYAGAM (NPI# 1730388067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730388067 |
| Entity Type | Individual |
| Full Name | DR. SHOBA THEIVANAYAGAM |
| Credential | M.D |
| Practice Address |
540 E Jefferson St Ste 102 Iowa City IA 52245-2460 |
| Mailing Address |
5105 N Glen Park Place Rd Peoria IL 61614-4675 |
| Practice Telephone | 3193375997 |
| Mailing Telephone | 3093085900 |
| Mailing Fax Number | 3093085910 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 125052380 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD-44502 | IA | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036.125213 | IL | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
2011001511 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5105 N Glen Park Place Rd, Peoria, IL 616144675 | 3093085900 | 3093085910 |
| Street Address |
540 E JEFFERSON ST STE 102 |
| City | IOWA CITY |
| State | IA |
| Zip Code | 52245-2460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669499000 | Yonas Getachew | Internal Medicine | 540 E Jefferson St Ste 102, Iowa City, IA 52245-2460 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699356 | Mary Beth Shapcott | Registered Nurse | 500 East Market St., Mercy Hospital Diabetes Education, Iowa City, IA 52245 | 2017-10-10 |
| 1366703167 | Elizabeth Bright | Occupational Therapist | 540 E. Jefferson Street., Ste.302, Iowa City, IA 52245 | 2012-06-07 |
| 1043518368 | Robert Brian Goffstein | Ophthalmology | 403 North 7th Ave, Iowa City, IA 52245 | 2011-03-10 |
| 1750682936 | Robert Alvin Blair | Dentist | 134 Broadmoor Lane, Iowa City, IA 52245 | 2010-11-04 |
| 1215167457 | Laura J Ericson | Occupational Therapist | 540 E Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-07-22 |
| 1780818294 | Kathryn Leigh Bossen | Physical Therapist | 540 E. Jefferson Street, Ste. 302, Iowa City, IA 52245 | 2009-05-12 |
| 1073751095 | Jessica L Keeran | Physical Therapist | 2751 Northgate Dr. Ne, Iowa City, IA 52245 | 2009-01-29 |
| 1437330370 | Francine Mardarello Hunnicutt | Marriage & Family Therapist | 1610 East College St, Iowa City, IA 52245 | 2007-11-20 |
| 1659574853 | Joan Victoria Rinner | Marriage & Family Therapist | 121 University Services Building, University of Iowa, Iowa City, IA 52245 | 2007-06-06 |
| 1053529966 | Steve Bernt Hammerstrom | Chiropractor | 373 B Scott Court, Iowa City, IA 52245 | 2007-05-21 |
| Find all providers in zip 52245 | ||||
| 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 |
|---|---|---|---|---|
| 1659895282 | Babatunde Olaiya | Internal Medicine | 200 Hawkins Drive, Department of Gastroenterology, Iowa City, IA 52242-1009 | 2017-07-25 |
| 1336661537 | Xiaocen Zhang | Internal Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2017-07-10 |
| 1184098667 | Tomohiro Tanaka | Internal Medicine | 200 Hawkins Dr, Dept of Internal Medicine, Iowa City, IA 52242-1009 | 2015-11-19 |
| 1922487941 | Xiaoping He | Internal Medicine | University of Iowa Hospitals and Clinics, Internal Medicine - Gi Division, Iowa City, IA 52242 | 2015-05-22 |
| 1457745937 | Amer El Sayed | Internal Medicine | 200 Hawkins Dr, Dept of Internal Medicine, Iowa City, IA 52242-1009 | 2015-03-23 |
| 1225444862 | Barakat Kh. M.b Aburajab Altamimi | Internal Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242-1009 | 2014-07-03 |
| 1831504380 | Divya Ashat | Internal Medicine | 200 Hawkins Dr Dept Of, Iowa City, IA 52242 | 2014-06-24 |
| 1033418843 | Randhir Jesudoss | Internal Medicine | 200 Hawkins Dr, Jcp 4547, Iowa City, IA 52242-1009 | 2011-03-18 |
| 1699082149 | Huy Tran | Internal Medicine | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2010-09-03 |
| 1386803187 | Mohamad Mokadem | Internal Medicine | 200 Hawkins Dr, 4570 Jcp, Iowa City, IA 52242-1009 | 2008-06-05 |
| Find all providers in IOWA CITY | ||||
Please comment or provide details below to improve the information on DR. SHOBA THEIVANAYAGAM.
| 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.