Individual provider Active NPI

Alexa Nimmagadda, APRN

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1821821596
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.030311 Issued in IL
Practice address
2551 N Clark St Ste 100
Chicago, IL 60614-7737
Phone
(773) 388-2322
Fax
(773) 388-2333
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.048084 IL
Nurse Practitioner 363L00000X 209.030311 IL Primary

Addresses

Primary practice location

2551 N Clark St Ste 100
Chicago, IL 60614-7737

Mailing address

2551 N Clark St Ste 100
Chicago, IL 60614-7737
Phone (773) 388-2322

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241119001494 IL Practitioner - Nurse Practitioner 7416482179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Family Asthma and Allergy SCGroup PAC ID 7214084672, 3 clinicians

Practice addresses (Care Compare)

2551 N Clark St
Suite 100
Chicago, IL 60614-7737
Phone (773) 388-2322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.048084ILMDRegistered Nurse
209.030311ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Family Asthma & Allergy SC CurrentSince Aug 26, 2024 Accepting new patients

Locations

2551 N Clark St
#100
Chicago, IL 60614

2551 N Clark St
Ste 201
Chicago, IL 60614
Phone (773) 388-2322

2551 N Clark St
Ste 100
Chicago, IL 60614
Phone (773) 388-2322

836 W Wellington Ave
Ste G
Chicago, IL 60657
Phone (773) 388-2322

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1821821596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 N CLARK ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147737",
            "telephone_number": "773-388-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 N CLARK ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147737",
            "telephone_number": "773-388-2322",
            "fax_number": "773-388-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIMMAGADDA",
        "first_name": "ALEXA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.048084",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.030311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.