DR. POOJA SHETH-DUTT (NPI# 1346735065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346735065 |
| Entity Type | Individual |
| Full Name | DR. POOJA SHETH-DUTT |
| Other Name | DR. POOJA SHETH |
| Credential | MD |
| Practice Address |
520 N 4th St Springfield IL 62794 |
| Mailing Address |
Po Box 19670 Springfield IL 62794-9670 |
| Practice Telephone | 2175458000 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2177578161 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 125072847 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
520 N 4TH ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023006913 | Janet R Albers | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2005-10-13 |
| 1316559529 | Andrea Dawn Peterson | Social Worker | 520 N 4th St, Springfield, IL 62702-5238 | 2020-08-19 |
| 1811505159 | Naila Manahil | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-07-22 |
| 1881211605 | Roxanne Bautista | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-06-27 |
| 1689298366 | Ibukunoluwa Oluwatoni Olapoju | Family Medicine | 520 N 4th St, Springfield, IL 62702 | 2020-05-29 |
| 1386267425 | George Hudson | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-05-23 |
| 1962025577 | Logan Tyler Garthe | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-05-19 |
| 1740802693 | Haroun Babajide Ogun | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-05-14 |
| 1952923153 | Hayley Hudson | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-05-11 |
| 1780206094 | Patrick Hale Long | Family Medicine | 520 N 4th St, Springfield, IL 62702-5238 | 2020-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1851646566 | Kenneth David Illingworth | Orthopaedic Surgery | 301 N 8th St Pav 3a158, Springfield, IL 62794 | 2012-07-18 |
| 1255623997 | Venkata Sasidhar Majjiga | Pediatrics | 301 N 8th Street, Siu School of Medicine, Pediatrics, Room 3a169, Springfield, IL 62794 | 2011-05-13 |
| 1205810082 | Michael R Pranzatelli | Psychiatry & Neurology | Southern Illinois University Healthcare Administration, Springfield, IL 62794 | 2005-12-05 |
| 1558511519 | John Wang | Emergency Medicine | 520 North Fourth Street, Springfield, IL 62794 | 2008-09-26 |
| 1659431351 | University of Illinois | Public Health or Welfare | 2815 W Washington, Suite 300, Springfield, IL 62794-9481 | 2006-12-11 |
| 1750645263 | Schuyler Whitney Stone | Internal Medicine | 701 North 1st Street, Springfield, IL 62794-9636 | 2012-06-28 |
| 1083695811 | John Mark Ruscin | Pharmacist | 701 N. First Street, Springfield, IL 62794-9636 | 2005-11-09 |
| 1053750851 | Ashley Patricia Macdonald | Family Medicine | 520 N Fourth St, Springfield, IL 62794-9670 | 2013-06-14 |
| 1386759264 | David Buoy Graham | Family Medicine | 520 North 4th Street, Springfield, IL 62794-9670 | 2006-08-20 |
| Find all providers in zip 62794 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62794 |
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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.