Active NPI
Ronald D Fillmore, CRNFA
- Registered Nurse First Assistant
- Long Beach, CA
National Provider Identifier
1003019282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- 305990
- Practice address
- 2776 Pacific Ave
Pacific Hospital of Long Beach
Long Beach, CA 90806-2613 - Phone
- (760) 534-9550
- Fax
- (951) 808-9700
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 305990 | CA | Primary |
Addresses
Primary practice location
2776 Pacific Ave
Pacific Hospital of Long Beach
Long Beach, CA 90806-2613
Mailing address
PO Box 6580
Long Beach, CA 90806-6580
Phone (760) 534-9550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305990 | Other | CA | CRNFA LIC NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305990 | CA | MD | Registered Nurse First Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003019282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6580",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908066580",
"telephone_number": "760-534-9550",
"fax_number": "951-808-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2776 PACIFIC AVE",
"address_2": "PACIFIC HOSPITAL OF LONG BEACH",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062613",
"telephone_number": "760-534-9550",
"fax_number": "951-808-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FILLMORE",
"first_name": "RONALD",
"middle_name": "D",
"credential": "CRNFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "CA",
"license": "305990",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNFA LIC NUMBER",
"identifier": "305990",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.