Sujay Nakka

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

500697789 Issued in OR

Practice address

706 Meadow Ave
Tillamook, OR 97141-2844

Phone

(503) 354-2523

Fax

(503) 354-5116

NPI assigned

Aug 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Meadowland Adult Foster Home LLC

  • Assisted Living Facility (Behavioral Disturbances)
  • Tillamook, OR
  • NPI 1508215252
  NPD (past) Authorized official

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1932654118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 MEADOW AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412844",
            "telephone_number": "503-354-2523",
            "fax_number": "503-354-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 MEADOW AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412844",
            "telephone_number": "503-354-2523",
            "fax_number": "503-354-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKKA",
        "first_name": "SUJAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "500697789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON HEALTH AUTHORITY",
            "identifier": "500697789",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Niels Stephen Mitchell
• Lyle Rowland Mohr, MD
• MSM Investments LLC
• James C Munly, MD
• Jessica A Murren
• National Vision, Inc.
• Heather Neal
• Andrew Frederick Nelson, M.D.
• Curtis R Nerness, MD
• Faye M Newcomb, MS

• Case Manager/Care Coordinator in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.