DR. ROGER SEBASTIAN SHINNERL M.D. NPI 1760684765

NPI Information

NPI: 1760684765
Provider Name: DR. ROGER SEBASTIAN SHINNERL, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
305 W JACKSON ST STE 206
CARBONDALE, IL
ZIP 62901
Phone: (618) 457-3006
Get Directions

DR. Roger Sebastian Shinnerl, M.D. is a vascular surgery surgery in Carbondale, IL with 30 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Roger Sebastian Shinnerl, M.D. NPI is 1760684765. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

305 W JACKSON ST STE 206
CARBONDALE, IL
ZIP 62901-474
Phone: (618) 457-3006

The NPI 1760684765 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 1/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	036166938	ILLINOIS	Yes
2	2086S0129X	Surgery	Vascular Surgery	01063822A	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100035620	MEDICAID	KENTUCKY
2	00001666778	OTHER	INDIANA	BCBS
3	01063822A	OTHER	INDIANA	STATE LICENSE
4	01063822B	OTHER	INDIANA	STATE CSR
5	300063165	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »