Shelley R Hasselman, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

20149 Issued in CA

Practice address

29099 Hospital Road
Suite 204B
Lake Arrowhead, CA 92352

Phone

(909) 337-7771

Fax

(909) 337-5353

NPI assigned

Oct 8, 2010

Last updated

Oct 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment Care Compare group NPD
• Southern California Emergency Medicine

  dba Riverside Urgent Care La Sierra

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1063191575
  NPD
• Southern California Emergency Medicine

  dba Redlands Urgent Care

  • Urgent Care Clinic/Center
  • Redlands, CA
  • NPI 1457888034
  NPD

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1003126129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2482",
            "city": "RUNNING SPRINGS",
            "state": "CA",
            "postal_code": "923822482",
            "telephone_number": "909-867-2814",
            "fax_number": "909-337-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29099 HOSPITAL ROAD",
            "address_2": "SUITE 204B",
            "city": "LAKE ARROWHEAD",
            "state": "CA",
            "postal_code": "92352",
            "telephone_number": "909-337-7771",
            "fax_number": "909-337-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSELMAN",
        "first_name": "SHELLEY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "626568",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "20149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Edith Galvin, RNC FNP PHD
• Garfield Beach CVS LLC (CVS Pharmacy # 10999)
• Guy Gerald Giacopuzzi, DDS
• John Clarke Hankey, MD
• Jay Allen Hartstein, MD
• Erika Brigitte Herrmann, FNP
• Katherine Victoria Herzog, NP
• Hi-Land Mountain Homes (Above it All Alcohol & Drug Treatment Center)
• Kwangja Lee Hong, CRNA
• Corey K Houmand, DDS

• Primary Care Nurse Practitioner in Lake Arrowhead, CA
• Providers in Lake Arrowhead, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; 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.