Individual provider Active NPI

Anita Whitaker, NP

  • Nurse Practitioner
  • Hughson, CA
National Provider Identifier
1720041494
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP2398 Issued in CA
Practice address
2412 3Rd Street
Hughson, CA 95326
Phone
(209) 558-7250
NPI assigned
Apr 11, 2006
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP2398 CA Primary

Addresses

Primary practice location

2412 3Rd Street
Hughson, CA 95326

Mailing address

917 Oakdale Rd
Modesto, CA 95355-4593
Phone (209) 558-7248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200430000624 CA Practitioner - Nurse Practitioner 5092931485 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP2398CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lumira Healthcare Current Accepting new patients
Lumira Healthcare CurrentSince Mar 2, 2020 Accepting new patients
Lumira Healthcare CurrentSince Mar 2, 2020 Accepting new patients
Lumira Healthcare PastSince Aug 1, 2020 Accepting new patients
County of Stanislaus Past Accepting new patients
Lumira Healthcare Past Accepting new patients

Locations

16233 King St
Delhi, CA 95315
Phone (833) 850-3500

7970 Lander Ave
Ste Ab
Hilmar, CA 95324
Phone (209) 262-1819

2412 3rd St
Hughson, CA 95326
Phone (209) 558-7250

1140 Main St
Livingston, CA 95334
Phone (209) 394-7913

1617 Main St
Livingston, CA 95334
Phone (209) 850-2003

600 B St
Livingston, CA 95334
Phone (833) 850-3500

600 B St
Ste B
Livingston, CA 95334

12619 Bentley St
Waterford, CA 95386
Phone (209) 442-6200

Interoperability endpoints

  • Direct secure messaging: anita.whitaker.p3@direct.livingstoncommunity.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1720041494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 OAKDALE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554593",
            "telephone_number": "209-558-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 3RD STREET",
            "city": "HUGHSON",
            "state": "CA",
            "postal_code": "95326",
            "telephone_number": "209-558-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "ANITA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP2398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hughson, CA

Sources for this page

Verify at the official NPI Registry.