Shivas Gilotra, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP08554 Issued in LA

Practice address

805 Oberlin Road
Ste 200
Raleigh, NC 27604

Phone

(919) 322-4722

NPI assigned

Jan 6, 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 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: sgilotra33845@fastmed.direct-ci.com

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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• North Carolina Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Laurinburg, NC
  • NPI 1003861386
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  NPD
• Capital Foot and Ankle Centers

  • Foot & Ankle Surgery Podiatrist
  • Raleigh, NC
  • NPI 1235666710
  NPD (past)
• Med First Immediate Care & Family Practice PA

  • Family Medicine Physician
  • Chapel Hill, NC
  • NPI 1255851358
  NPD (past)
• Raleigh Medical Group, PA

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1104962315
  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1972969913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 BELMONT VIEW LOOP",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275197725",
            "telephone_number": "504-251-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 OBERLIN ROAD",
            "address_2": "STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27604",
            "telephone_number": "919-322-4722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4104 Surles Ct Ste 11",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277038239",
            "country_code": "US",
            "telephone_number": "919-941-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILOTRA",
        "first_name": "SHIVAS",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP08554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01106379",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2413384",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Grace Gillis, LCSWA
• Katherine Anne Gillis, PA-C
• Alesia Perkins Gilmore, MS, LCMHC, LPC
• Katherine Ann Gilmore, PNP-PC
• Shelley Lynn Gilmore, L.C.S.W.
• Christine May Gilsdorf, MA, LAT, ATC
• Melissa Cathleen Ginesi, AUDIOLOGIST
• Meridith Colleen Ginesi, M.D.
• Ginie Home Care Services Inc
• Tracy Benick Ginn, L.P.C., L.M.H.C.

• Family Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.