Nikita Sarath Gummadi, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209018623 Issued in IL

Practice address

3450 Oakton St
Skokie, IL 60076-2951

Phone

(773) 401-4300

NPI assigned

Jan 16, 2019

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

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Longevity Clinical LTC Associates of Illinois PLLC

  • Primary Care Nurse Practitioner
  • Chicago, IL
  • NPI 1407422447
  Medicare reassignment NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment NPD
• Longevity Accountable Care, PA

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1144078965
  Medicare reassignment

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1770057440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 N MARINE DR APT 1407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403996",
            "telephone_number": "847-791-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OAKTON ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762951",
            "telephone_number": "773-401-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMMADI",
        "first_name": "NIKITA",
        "middle_name": "SARATH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209018623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Guiab
• Diana Guillaume, NP
• Linda Guillermo, LCSW, ACSW
• Stephanie Guliana
• Jasmine Jenine Gulley Brown, IAMFT
• Julia Gunina
• Chander Gupta, DMD
• Mikhail Gurovich, PHD, MPH, CADC, MISA
• Linda K Gustafson, PH.D.
• Gustavson & Robbins DDS, LTD

• Primary Care Nurse Practitioner in Skokie, IL
• Providers in Skokie, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.