Ramesh Gautam, DNP
Individual provider Active NPI Primary Care Nurse Practitioner · Fort Eustis, VA
NPI 1497360689 · NPPES record last updated Apr 2, 2026
Key facts
- NPI
- 1497360689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 1091132 (TX)
- Practice address
- 576 Jefferson Ave
Fort Eustis, VA 23604-1373 - Phone
- (757) 314-7500
- NPI assigned
- Sep 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1091132 | TX | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoebe Physician Group, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1091132 | TX | Yes |
Addresses
Primary practice location
576 Jefferson Ave
Fort Eustis, VA 23604-1373
Mailing address
576 Jefferson Ave
Fort Eustis, VA 23604-1373
Phone (757) 314-7500
Other providers in Fort Eustis, VA
- Honora Nicolai Francis
- Landon Sterling Frost
- Adam Garcia-Manfredi
- Kevin Edward Garner
- Julie Garskof
- Keitra Tunisha George
- Sara Gillette
- Richard Daivd Glaeser
- Jeffrey Thomas Glasser
- Raimund R Glosson
All providers in Fort Eustis, VA · Primary Care Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.