Individual provider Active NPI

Shanti Gurung, FNP-C

  • Family Nurse Practitioner
  • Henrico, VA
National Provider Identifier
1386304301
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024182362 Issued in VA
Practice address
9000 Staples Mill Rd
Henrico, VA 23228-2021
Phone
(804) 977-9526
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 0024182362 VA Primary

Addresses

Primary practice location

9000 Staples Mill Rd
Henrico, VA 23228-2021

Mailing address

9000 Staples Mill Rd
Henrico, VA 23228-2021
Phone (804) 977-9526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220110002011 VA Practitioner - Nurse Practitioner 5890186555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Virginia Commonwealth University, School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Primary Care LLCGroup PAC ID 3476986613, 91 clinicians

Practice addresses (Care Compare)

1362 Tappahannock Blvd
Tappahannock, VA 22560-9309
Phone (804) 443-5378

2421 Chamberlayne Ave
Richmond, VA 23222-4205
Phone (804) 329-8510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024182362VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Primary Care LLC Single Specialty CurrentSince Oct 24, 2022 Accepting new patients
Little Clinic of VA LLC Single Specialty CurrentSince Jun 1, 2022 Accepting new patients
Commonwealth Counseling Associates Inc Single Specialty Past Accepting new patients

Locations

7000 Tim Price Way
North Chesterfield, VA 23225
Phone (804) 772-8541

2421 Chamberlayne Ave
Richmond, VA 23222
Phone (804) 329-8510

9000 Staples Mill Rd
Richmond, VA 23228
Phone (804) 977-9515

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1386304301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 STAPLES MILL RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282021",
            "telephone_number": "804-977-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 STAPLES MILL RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282021",
            "telephone_number": "804-977-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURUNG",
        "first_name": "SHANTI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2022-08-01",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.