Heather Nimmagadda, MS, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209004994 Issued in IL

Practice address

3001 6TH St
Great Lakes, IL 60088-2833

Phone

(847) 688-4560

NPI assigned

May 2, 2010

Last updated

May 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science

State licenses

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272758400000",
    "number": "1689991507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 RFD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600472023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMAGADDA",
        "first_name": "HEATHER",
        "credential": "MS, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2010-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209004994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NBHC NCTC Inpr Great Lakes
• NBHC NTC Great Lakes
• Dane Nelson, D.D.S.
• Andrew Trinh Nguyen, DDS
• Jose Alfredo Nicola, IDC
• James Ted Norris Jr., M.D.
• John Francis Novak, D.C.
• Francisco Obedoza, M.D.
• Judith Ann Ogara, LD
• John Clifford Olsen, M.D.

• Pediatric Nurse Practitioner in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.