Individual provider Active NPI

Shylaja Nuguri, MD

  • Pediatrics Physician
  • Lexington, KY
National Provider Identifier
1255303863
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
52329 Issued in KY
Practice address
496 Southland Dr
Lexington, KY 40503-1827
Phone
(859) 288-2425
Fax
(859) 899-5224
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52329 KY Primary

Addresses

Primary practice location

496 Southland Dr
Lexington, KY 40503-1827

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190926002368 KY Practitioner - Pediatric Medicine 9830144419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37401SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthfirst Bluegrass Inc CurrentSince Aug 1, 2019 Accepting new patients
Healthfirst Bluegrass Inc. CurrentSince Aug 1, 2019 Accepting new patients

Locations

496 Southland Dr
Lexington, KY 40503
Phone (859) 288-2392

1640 Bryan Station Rd
Ste 1
Lexington, KY 40505

Interoperability endpoints

  • Direct secure messaging: shylaja.nuguri.1@32600.direct.athenahealth.com

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1255303863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2392",
            "fax_number": "859-721-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2425",
            "fax_number": "859-899-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGURI",
        "first_name": "SHYLAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "52329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.