Anita Whitaker, NP
Individual provider Active NPI Nurse Practitioner · Hughson, CA
NPI 1720041494 · NPPES record last updated Jul 17, 2023
Key facts
- NPI
- 1720041494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- NP2398 (CA)
- Practice address
- 2412 3Rd Street
Hughson, CA 95326 - Phone
- (209) 558-7250
- NPI assigned
- Apr 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200430000624 | CA | Practitioner - Nurse Practitioner | 5092931485 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP2398 | CA | MD | Nurse Practitioner |
| 2398 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lumira Healthcare | Current |
Accepting new patients | |
| Lumira Healthcare | Current | Accepting new patients | |
| Lumira Healthcare | Current |
Accepting new patients | |
| County of Stanislaus | Past | Accepting new patients | |
| Lumira Healthcare | Past | Accepting new patients | |
| Lumira Healthcare | Past |
Accepting new patients |
Locations
16233 King St
Delhi, CA 95315
Phone (209) 394-7913
7970 Lander Ave
Ste Ab
Hilmar, CA 95324
Phone (209) 262-1819
2412 3rd St
Hughson, CA 95326
Phone (209) 558-7250
600 B St
Ste B
Livingston, CA 95334
Phone (209) 850-3500
1140 Main St
Livingston, CA 95334
Phone (209) 394-7913
1617 Main St
Livingston, CA 95334
Phone (209) 394-7913
600 B St
Livingston, CA 95334
Phone (209) 850-3500
12619 Bentley St
Waterford, CA 95386
Phone (209) 442-6200
Interoperability endpoints
- anita.whitaker.p3@direct.livingstoncommunity.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP2398 | CA | Yes |
Addresses
Primary practice location
2412 3Rd Street
Hughson, CA 95326
Mailing address
917 Oakdale Rd
Modesto, CA 95355-4593
Phone (209) 558-7248
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN360549 | Other | CA | MEDICAL |
Other providers in Hughson, CA
All providers in Hughson, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.