Chardilaine Whitlock, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95021542 Issued in CA

Practice address

475 Bruce St
Yreka, CA 96097-3474

Phone

(530) 842-4121

NPI assigned

Aug 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of California, Davis School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Medicare reassignment Care Compare group NPD
• Gateway Medical Services, Inc.

  • Family Medicine Physician
  • Palo Cedro, CA
  • NPI 1770993370
  Medicare reassignment NPD
• St. Joseph Health Northern California, LLC

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1043292303
  Medicare reassignment NPD
• Gateway Medical Center Inc

  • General Practice Physician
  • Anderson, CA
  • NPI 1275685414
  NPD
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  NPD

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

• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  Care Compare affiliation

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1083342083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 WALNUT DR",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955036223",
            "telephone_number": "209-985-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-4121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4130 Walnut Dr",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955036223",
            "country_code": "US",
            "telephone_number": "209-985-0019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "CHARDILAINE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Well Pelvic Health and Physical Therapy LLC
• James M. Wheat Jr.
• Bryan Alexander Wheeler, RN
• Daryl Wheeler
• Phillip Jon White, P.T.
• M Kit Whitney, MFTI
• Tina Wilcox
• William King Thompson III
• Terry Williams, OD
• Paul William Willis, RPH

• Family Nurse Practitioner in Yreka, CA
• Providers in Yreka, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.