Individual provider Active NPI

Jessica Kay Chitumalla, ARNP

  • Gerontology Nurse Practitioner
  • Ocala, FL
National Provider Identifier
1184022014
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
ARNP9335117 Issued in FL
Practice address
2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone
(352) 622-4231
Fax
(352) 622-0513
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP9335117 FL Primary

Addresses

Primary practice location

2980 SE 3Rd CT
Ocala, FL 34471-0421

Mailing address

2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone (352) 622-4231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150128001062 FL Practitioner - Nurse Practitioner 4284958901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocala Kidney Group IncGroup PAC ID 5092795054, 13 clinicians

Practice addresses (Care Compare)

2980 SE 3Rd CT
Ocala, FL 34471-0421
Phone (352) 622-4231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Ocala Kidney Group Inc CurrentSince Jul 25, 2021 Accepting new patients
Ocala Kidney Group Inc CurrentSince Dec 10, 2014 Accepting new patients

Locations

8613 SW 103rd Street Rd
Ocala, FL 34481
Phone 3526224231 ext. 270

2980 SE 3rd Ct
Ocala, FL 34471
Phone (352) 622-4231

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1184022014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 SE 3RD CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710421",
            "telephone_number": "352-622-4231",
            "fax_number": "352-622-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 SE 3RD CT",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344710421",
            "telephone_number": "352-622-4231",
            "fax_number": "352-622-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITUMALLA",
        "first_name": "JESSICA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9335117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.