Individual provider Active NPI

Shivani Rani Gupta

  • Pediatric Gastroenterology Physician
  • Akron, OH
National Provider Identifier
1790170561
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
34.012646 Issued in OH
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, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222002945 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9931400637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.012646OHMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.