Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1801845607 Individual Practitioner Female Practitioner

Dr. Latha Shivashankar , MD

Pediatrics • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Latha Shivashankar, MD is a registered healthcare professional specializing in Pediatrics in Jacksonville, FL. Practice services are available at 11512 LAKE MEAD AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11512 Lake Mead Ave
Suite 201

Jacksonville, FL 322569680

Telephone 9049981448
Fax 9049981450
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.6 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
221 Specialists

Practicing in Jacksonville, FL (4160 Statewide)

Telehealth Adoption Rate
0.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME53102

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
058765600 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

34 Associated Practitioners
Tanya Dilmuth , ARNP

Nurse Practitioner - Adult Health

NPI 1013391994

Advanced Registered Nurse Practitioner

Dr. Tanya Hunter , MD

Family Medicine

NPI 1033397989

Doctor of Medicine (M.D.)

Elizabeth O'grady , MS CCC-SLP

Speech-Language Pathologist

NPI 1043312663

MSCCCSLP

Michelle Klindtworth , CCC-SLP

Speech-Language Pathologist

NPI 1053629618

Speech-Language Pathologist (Certificate of Clinical Competence)

Juliann Abecassis

Acupuncturist

NPI 1073068235
Melissa Amerson , SLP

Speech-Language Pathologist

NPI 1083847677

Speech-Language Pathologist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 29, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location November 29, 2012

Registered at 11512 LAKE MEAD AVE, SUITE 201, JACKSONVILLE, FL 322569680 (Tel: 9049981448)

📍
Updated Business Mailing Address November 29, 2012

Registered at 11512 LAKE MEAD AVE, SUITE 201, JACKSONVILLE, FL 32256 (Tel: 9049981448)

👤
Provider Name / Credentials Updated November 29, 2012

Recorded as LATHA SHIVASHANKAR, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 29, 2012

Pediatrics (License #ME53102 in FL)

🟢
Initial NPI Registration & Enumeration May 09, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801845607
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 09, 2006
Last Update: November 29, 2012
Sole Proprietor: Yes

Mailing Address

11512 Lake Mead Ave, Suite 201

Jacksonville, FL 32256

Phone: 9049981448

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.