Individual provider Active NPI

Lori Kortkamp, FNP-C

  • Family Nurse Practitioner
  • Huntington Beach, CA
National Provider Identifier
1083249353
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013689 Issued in CA
Practice address
6762 Warner Ave Apt M2
Huntington Beach, CA 92647-5324
Phone
(562) 253-3122
NPI assigned
Mar 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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 95013689 CA Primary

Addresses

Primary practice location

6762 Warner Ave Apt M2
Huntington Beach, CA 92647-5324

Mailing address

6762 Warner Ave Apt M2
Huntington Beach, CA 92647-5324
Phone (562) 253-3122

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL LoriFNP1@gmail.com

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
I20210915003857 CA Practitioner - Nurse Practitioner 7012314115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
81.09

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Medical Clinic, Inc Family Medicine CurrentSince May 20, 2021 Accepting new patients
Good Samaritan Medical Clinic Current Accepting new patients

Locations

801 N Harbor Blvd
Anaheim, CA 92805
Phone (714) 337-4640

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": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1083249353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6762 WARNER AVE APT M2",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475324",
            "telephone_number": "562-253-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6762 WARNER AVE APT M2",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475324",
            "telephone_number": "562-253-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTKAMP",
        "first_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LoriFNP1@gmail.com",
            "affiliation": "N",
            "address_1": "6762 Warner Ave Apt M2",
            "city": "Huntington Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926475324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.