Individual provider Active NPI

Noarie Iverie Magoun, DNP

  • Acute Care Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1023778024
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95019412 Issued in CA
Practice address
12677 Hesperia Rd Ste 130
Victorville, CA 92395-7735
Phone
(760) 241-7763
Fax
(760) 241-6383
NPI assigned
Dec 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2100X 95019412 CA Primary

Addresses

Primary practice location

12677 Hesperia Rd Ste 130
Victorville, CA 92395-7735

Mailing address

12677 Hesperia Rd Ste 130
Victorville, CA 92395-7735
Phone (760) 241-7763

Other names 1

  • Noarie Iverie Caraballo Former name

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
I20240514002457 CA Practitioner - Nurse Practitioner 3577904176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joel Q Velasquez MD IncGroup PAC ID 9830372358, 3 clinicians

Practice addresses (Care Compare)

12677 Hesperia Rd
Suite 130
Victorville, CA 92395-7735
Phone (760) 241-7763

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19354/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GBJDAA/Endpoint/GBJDAA

Organizations & group practices 1

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": "1639872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1023778024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12677 HESPERIA RD STE 130",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957735",
            "telephone_number": "760-241-7763",
            "fax_number": "760-241-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12677 HESPERIA RD STE 130",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957735",
            "telephone_number": "760-241-7763",
            "fax_number": "760-241-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGOUN",
        "first_name": "NOARIE",
        "middle_name": "IVERIE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-19",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95019412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOARIE",
            "last_name": "CARABALLO",
            "middle_name": "IVERIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.