Active NPI
Ishita Kothari Varma, AGNP
- Primary Care Nurse Practitioner
- Long Beach, CA
National Provider Identifier
1013662030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 95017804
- Practice address
- 5901 E 7TH St
Long Beach, CA 90822-5201 - Phone
- (562) 826-8000
- NPI assigned
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 95017804 | CA | |
| Gerontology Nurse Practitioner | 363LG0600X | 95017804 | CA | |
| Primary Care Nurse Practitioner | 363LP2300X | 95017804 | CA | Primary |
Addresses
Primary practice location
5901 E 7TH St
Long Beach, CA 90822-5201
Mailing address
4116 E Addington Dr
Anaheim, CA 92807-2813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95017804 | CA | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1013662030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4116 E ADDINGTON DR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928072813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 E 7TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908225201",
"telephone_number": "562-826-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARMA",
"first_name": "ISHITA",
"middle_name": "KOTHARI",
"credential": "AGNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-17",
"last_updated": "2022-02-17",
"certification_date": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "95017804",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95017804",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "CA",
"license": "95017804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.