SHELLY RUSTAGI (NPI# 1962762161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962762161 |
| Entity Type | Individual |
| Full Name | SHELLY RUSTAGI |
| Credential | M.D. |
| Practice Address |
1 Childrens Plz Dayton OH 45404-1873 |
| Practice Telephone | 9376414000 |
| Practice Fax Number | 9376414500 |
| Mailing Telephone | 9376413090 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2019-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
35.129057 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0178798 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3333 W Tech Blvd, Miamisburg, OH 453420955 | 9376413000 | 9376414500 |
| Street Address |
1 CHILDRENS PLZ |
| City | DAYTON |
| State | OH |
| Zip Code | 45404-1873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021324 | Dayton Children's Orthopaedic Center for Spinal & Pediatric Care, LLC | Specialist | 1 Childrens Plz, Dayton, OH 45404 | 2005-05-23 |
| 1346840782 | Lillian Delatore | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-10-26 |
| 1760081434 | Jennifer P Slye | Counselor | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-10-22 |
| 1255942868 | Dayton Children's Hospital | Pharmacy | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-08-17 |
| 1851917744 | Kylie Lynn Yike | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-06-17 |
| 1750901211 | Mitchell Alexander Mcclellan | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-24 |
| 1902426935 | Preston Keiffer | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-04-20 |
| 1336768829 | Emily Dippold | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-14 |
| 1811516875 | Courtney Ann Pierron | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-10 |
| 1790304905 | Kate Redding Boroff | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134587108 | Addison Home Health Services LLC | Nursing Care | 1819 Troy St Ste 3, Dayton, OH 45404 | 2016-02-05 |
| 1437593951 | Ronna Sue Tilley | Licensed Practical Nurse | 550 Dawes Avenue, Dayton, OH 45404 | 2013-04-26 |
| 1932397544 | Children's Anesthesia Group Inc | Anesthesiology | 1 Children's Plz, Dayton, OH 45404 | 2007-10-09 |
| 1922135292 | Donald J Elsbernd Dds Inc | Dentist | 825 Troy St, Dayton, OH 45404 | 2007-02-27 |
| 1124172036 | Mary Ann Wallace | Home Delivered Meals | 900 Troy Street, Dayton, OH 45404 | 2007-01-22 |
| 1225094287 | Ann E Burke | Pediatrics | One Childrens Plaza, Dayton, OH 45404 | 2006-04-26 |
| 1508838244 | Virginia G Matheson | Psychiatry & Neurology | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2006-02-06 |
| 1952921710 | Daniel Oder | Student in an Organized Health Care Education/Training Program | 1 Children's Plaza, Dayton Children's Hospital, Cheri Russell, Dayton, OH 45404 | 2020-04-22 |
| 1356802276 | Alec Kelley | Student in an Organized Health Care Education/Training Program | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2019-03-26 |
| 1205360831 | Chiara Foster | Student in an Organized Health Care Education/Training Program | 1 Childrens Plaza, Dayton, OH 45404 | 2017-04-20 |
| Find all providers in zip 45404 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720314768 | Kathryn Leanne Williams | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1873 | 2009-10-27 |
| 1922269133 | Kelly Sandberg | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1873 | 2008-06-19 |
| 1427220276 | Pramodha Muniyappa | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1898 | 2008-04-01 |
| 1013194802 | Ramakrishna Mutyala | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1873 | 2008-01-24 |
| 1689602708 | Michael D Bates | Pediatrics | 1 Childrens Plz, Dayton, OH 45404 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689179038 | Simon Lam | Pediatrics | 3333 Burnet Ave # Mlc5016, Cincinnati, OH 45229-3026 | 2018-03-28 |
| 1629368865 | Jessica Nora Barry | Pediatrics | 9500 Euclid Avenue R3, Cleveland Clinic, Cleveland, OH 44195 | 2011-04-08 |
| 1346350212 | Shehzad A Saeed | Pediatrics | 3333 Burnet Ave, Ml 2010, Cincinnati, OH 45229-3026 | 2006-08-30 |
| 1629096342 | Joseph J Palermo | Pediatrics | 3333 Burnet Ave., Ml 2010, Cincinnati Children's Hospital, Cincinnati, OH 45229-3039 | 2006-07-18 |
| 1669402087 | Mike A Leonis | Pediatrics | 9500 Euclid Ave # R3, Cleveland, OH 44195-0001 | 2006-07-03 |
| 1891724530 | Samuel A Kocoshis | Pediatrics | 3333 Burnet Ave Ml 2010, Cincinnati, OH 45229-3026 | 2006-07-03 |
| 1700828464 | Conrad R Cole | Pediatrics | 3333 Burnet Avenue Mlc 2010, Cincinnati Children's Hospital, Cincinnati, OH 45229-3026 | 2006-06-10 |
| 1366401960 | Ibrahim J Haddad | Pediatrics | 7641 Market St Ste 3, Boardman, OH 44512 | 2006-03-22 |
| 1447614508 | Mason Nistel | Pediatrics | 3333 Burnett Avenue, Ml 5018, Cincinnati, OH 45229-3039 | 2016-04-05 |
| 1831551563 | Corie Marie Klepper | Pediatrics | 3333 Burnet Ave, Cincinnati, OH 45229-3026 | 2016-03-22 |
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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.