Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164497186 Individual Practitioner Male Practitioner

Dr. Van Shantharam , MD

Specialist • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Van Shantharam, MD is a registered healthcare professional specializing in Specialist in Jacksonville, FL. Practice services are available at 2585 HERSCHEL ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2585 Herschel St

Jacksonville, FL 322044557

Telephone 9043882678
Fax 9043886776
Associated Practice Facility / Clinic
🏢 Clinic For Kidney Diseases Pa Facility NPI 1467471672

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.7 Yrs
State Avg: 37.8 Yrs
Regional Practice Density
107 Specialists

Practicing in Jacksonville, FL (3036 Statewide)

Telehealth Adoption Rate
0.9% 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

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License FL ME0035945

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
06999340 (FL)

Practice Associates & Co-Workers

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

7 Associated Practitioners
Dr. Prasanth Krish , MD

Internal Medicine - Nephrology

NPI 1023243888

Doctor of Medicine (M.D.)

Dr. Nilay Nahar , MD

Internal Medicine - Nephrology

NPI 1114992153

Doctor of Medicine (M.D.)

NPI 1144936667

Master of Science, Registered Dietitian Nutritionist, Licensed Dietitian Nutritionist

Dr. Shaun Aure , MD

Internal Medicine - Nephrology

NPI 1295940294

Doctor of Medicine (M.D.)

Dr. Dinesh Jayadevappa , MD

Internal Medicine - Nephrology

NPI 1467427492

Doctor of Medicine (M.D.)

Dr. Brijendra Gupta , MD

Internal Medicine - Nephrology

NPI 1639145352

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2585 HERSCHEL ST, JACKSONVILLE, FL 322044557 (Tel: 9043882678)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2585 HERSCHEL ST, JACKSONVILLE, FL 322044557 (Tel: 9043882678)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as VAN SHANTHARAM, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #ME0035945 in FL)

🟢
Initial NPI Registration & Enumeration February 22, 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: 1164497186
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 22, 2006
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

2585 Herschel St

Jacksonville, FL 322044557

Phone: 9043882678

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.