Individual provider Active NPI

Bosede Apata

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1033584909
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.013616 Issued in IL
Practice address
7906 S Crandon Ave Ste 7
Chicago, IL 60617-1146
Phone
(312) 842-7580
NPI assigned
Dec 3, 2015
Last updated
Nov 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.013616 IL Primary

Addresses

Primary practice location

7906 S Crandon Ave Ste 7
Chicago, IL 60617-1146

Mailing address

650 Grant St
Ste 7
Gary, IN 46404-1551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160722001948 IN Practitioner - Nurse Practitioner 1850684291 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.013616ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Pulmonary & Sleep Associates, Inc CurrentSince Nov 1, 2017 Accepting new patients
Heartland Hospice Services LLC CurrentSince Oct 11, 2023 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 31, 2023 Accepting new patients
All About Holistic Minds Current Accepting new patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Jul 25, 2023 Accepting new patients
Mid-South Home Care Services, LLC CurrentSince Oct 31, 2023 Accepting new patients
All About Holistic Minds Current Accepting new patients
Heartland Hospice Services, LLC CurrentSince Oct 11, 2023 Accepting new patients

Locations

7906 S Crandon Ave
Ste 7
Chicago, IL 60617
Phone (312) 285-7271

931 E 86th St
Ste 208
Indianapolis, IN 46240
Phone (317) 251-3012

9775 Crosspoint Blvd
Ste 118
Indianapolis, IN 46256
Phone (317) 381-0095

3001 S Valley Ave
Marion, IN 46953
Phone (317) 251-3012

8549 Madison Ave
Southport, IN 46227
Phone (317) 881-9164

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

L2540
Columbus, OH 43260

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1033584909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 GRANT ST",
            "address_2": "STE 7",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464041551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7906 S CRANDON AVE STE 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171146",
            "telephone_number": "312-842-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APATA",
        "first_name": "BOSEDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.013616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.