Individual provider Active NPI

Angela Noelle Murray, PA

  • Medical Physician Assistant
  • Fortuna, CA
National Provider Identifier
1063746287
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20502 Issued in CA
Practice address
3306 Renner Dr
Fortuna, CA 95540-3120
Phone
(707) 725-6101
Fax
(707) 725-2978
NPI assigned
Sep 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20502 CA Primary

Addresses

Primary practice location

3306 Renner Dr
Fortuna, CA 95540-3120

Mailing address

670 9TH Street
Suite 203
Arcata, CA 95521-6249
Phone (707) 826-8633

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
I20091202000582 CA Practitioner - Physician Assistant 5799824868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2200 Tydd St
Eureka, CA 95501-1284
Phone (707) 441-1624

3750 Rohnerville Rd
Fortuna, CA 95540-3118
Phone (707) 725-6101

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20502CAMDAddiction (Substance Use Disorder) Counselor
PA20502CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Sep 1, 2014 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers CurrentSince Sep 1, 2014 Accepting new patients
Open Door Community Health Centers Current Accepting new patients
Open Door Community Health Centers Current Accepting new patients

Locations

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

770 10th St
Arcata, CA 95521
Phone (707) 826-8610

1275 8th St
Arcata, CA 95521

550 E Washington Blvd
Crescent City, CA 95531
Phone (707) 465-4636

2200 Tydd St
Eureka, CA 95501
Phone (707) 269-7051

3304 Renner Dr
Fortuna, CA 95540
Phone (707) 725-4477

3306 Renner Dr
Fortuna, CA 95540
Phone (707) 725-6101

3750 Rohnerville Rd
Fortuna, CA 95540
Phone (707) 725-4477

670 9th St
Ste 203
McKinleyville, CA 95521

1644 Central Ave
McKinleyville, CA 95519
Phone (707) 839-3068

Interoperability endpoints

  • Direct secure messaging: amurray137976@direct.ochin.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1063746287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH STREET",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216249",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3306 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403120",
            "telephone_number": "707-725-6101",
            "fax_number": "707-725-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "ANGELA",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

Verify at the official NPI Registry.