Individual provider Active NPI

Supriya Bhuvanagiri

  • Hospitalist Physician
  • Rockford, IL
National Provider Identifier
1205530706
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.181757 Issued in IL
Practice address
5970 Churchview Dr
Rockford, IL 61107-2574
Phone
(815) 971-8990
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036.181757 IL
Hospitalist Physician 208M00000X 036.181757 IL Primary

Addresses

Primary practice location

5970 Churchview Dr
Rockford, IL 61107-2574

Mailing address

2604 Wydown LN
Aurora, IL 60502-4453

Other practice location 1

875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500

Other practice location 2

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Other practice location 3

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other practice location 4

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: sbhuvanagiri103538@direct.mhemail.org

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1205530706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 WYDOWN LN",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605024453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072574",
            "telephone_number": "815-971-8990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 S Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600148190",
            "country_code": "US",
            "telephone_number": "779-220-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Grant St",
            "address_purpose": "LOCATION",
            "city": "Harvard",
            "state": "IL",
            "postal_code": "600331821",
            "country_code": "US",
            "telephone_number": "815-943-5431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHUVANAGIRI",
        "first_name": "SUPRIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.181757",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.181757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.