Individual provider Active NPI

Jessica Merchant, DNP

  • Nurse Practitioner
  • La Jolla, CA
National Provider Identifier
1023627494
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95014916 Issued in CA
Practice address
9834 Genesee Ave Ste 412
La Jolla, CA 92037-1264
Phone
(858) 457-8600
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95014916 CA Primary

Addresses

Primary practice location

9834 Genesee Ave Ste 412
La Jolla, CA 92037-1264

Mailing address

6699 Alvarado Rd
Ste 2308
San Diego, CA 92120-5241
Phone (619) 462-9010

Other practice location 1

100 Park Plz Apt 1609
San Diego, CA 92101-8022
Phone (203) 627-8737

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
I20201102001159 CA Practitioner - Nurse Practitioner 8628488772 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 17, 2022 Accepting new patients
Michael L Butera MD Inc CurrentSince Sep 28, 2020 Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

6699 Alvarado Rd
Ste 2308
San Diego, CA 92120
Phone (619) 462-9010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1023627494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD",
            "address_2": "STE 2308",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205241",
            "telephone_number": "619-462-9010",
            "fax_number": "619-287-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE STE 412",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371264",
            "telephone_number": "858-457-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Park Plz Apt 1609",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921018022",
            "country_code": "US",
            "telephone_number": "203-627-8737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "JESSICA",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95014916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.