Individual provider Active NPI

Shalonte Allen-Carrasquillo, FNP

  • Family Nurse Practitioner
  • Lancaster, CA
National Provider Identifier
1013615186
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030375 Issued in CA
Practice address
43322 Gingham Ave
Lancaster, CA 93535-4576
Phone
(661) 874-4050
NPI assigned
Feb 20, 2023
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030375 CA Primary

Addresses

Primary practice location

43322 Gingham Ave
Lancaster, CA 93535-4576

Mailing address

9001 Stockdale Hwy
Bakersfield, CA 93311-1022
Phone (661) 654-2505

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241212001521 CA Practitioner - Nurse Practitioner 0749716819 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

Practice addresses (Care Compare)

43322 Gingham Ave
Lancaster, CA 93535-4576
Phone (661) 579-9317

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bartz-Altadonna Community Health Center CurrentSince Sep 30, 2024 Accepting new patients
Bartz-Altadonna Community Health Center CurrentSince Sep 30, 2024 Accepting new patients

Locations

12560 Boron Ave
Boron, CA 93516
Phone (760) 762-5064

43322 Gingham Ave
Lancaster, CA 93535
Phone (661) 579-9317

43322 Gingham Ave
Ste 105
Lancaster, CA 93535
Phone 6618744050222

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1013615186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 STOCKDALE HWY",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933111022",
            "telephone_number": "661-654-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43322 GINGHAM AVE",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935354576",
            "telephone_number": "661-874-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-CARRASQUILLO",
        "first_name": "SHALONTE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.