Active NPI
Shivani Rani Gupta
- Pediatric Gastroenterology Physician
- Akron, OH
National Provider Identifier
1790170561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 34.012646
- Practice address
- 215 W Bowery St FL 6
Akron, OH 44308-1069 - Phone
- (330) 543-7397
- NPI assigned
- Mar 30, 2015
- Last updated
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Gastroenterology Physician | 2080P0206X | 34.012646 | OH | Primary |
Addresses
Primary practice location
215 W Bowery St FL 6
Akron, OH 44308-1069
Mailing address
11819 Dorena Cir NW
Uniontown, OH 44685-6674
Phone (843) 371-4659
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sgupta121962@direct.chmca.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151222002945 | OH | Order and Referring Only - Pediatric Medicine | 9931400637 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34.012646 | OH | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Akron Children's Hospital | Current | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Children's Hospital Medical Center of Akron | Past | Accepting new patients | |
| Children's Hospital Medical Center of Akron | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Children's Hospital
- Akron, OH
- NPI 1942465752
-
dba Akron Children's Hospital-Physician Group
- Pediatrics Physician
- Akron, OH
- NPI 1841328853
-
dba Akron Children's Hospital
- Children's Hospital
- Akron, OH
- NPI 1861506560
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1790170561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11819 DORENA CIR NW",
"city": "UNIONTOWN",
"state": "OH",
"postal_code": "446856674",
"telephone_number": "843-371-4659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W BOWERY ST FL 6",
"city": "AKRON",
"state": "OH",
"postal_code": "443081069",
"telephone_number": "330-543-7397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "SHIVANI",
"middle_name": "RANI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-30",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "OH",
"license": "34.012646",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sgupta121962@direct.chmca.org",
"affiliation": "N",
"address_1": "215 W Bowery St Fl 6",
"city": "Akron",
"state": "OH",
"country_code": "US",
"postal_code": "443081069",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.