Individual provider Active NPI

Jill C Ross, NP

  • Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1083722540
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP 9011 Issued in CA
Practice address
4229 E 6TH St
Long Beach, CA 90814-1704
Phone
(562) 856-9385
NPI assigned
Aug 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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 NP 9011 CA Primary

Addresses

Primary practice location

4229 E 6TH St
Long Beach, CA 90814-1704

Mailing address

4229 E 6TH St
Long Beach, CA 90814-1704
Phone (562) 856-9385

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
I20190508003307 CA Practitioner - Nurse Practitioner 1052653219 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9011CAMDGeneral Acute Care Hospital
NP 9011CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansal Inc CurrentSince Sep 1, 2020 Accepting new patients
Inpatient Specialists of California, PC CurrentSince Dec 16, 2018 Accepting new patients

Locations

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1426 Montana Ave
Ste 2
Santa Monica, CA 90403
Phone (310) 388-6798

Interoperability endpoints

  • Direct secure messaging: jrossnp136586@direct.memorialcare.org

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": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1083722540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4229 E 6TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908141704",
            "telephone_number": "562-856-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 E 6TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908141704",
            "telephone_number": "562-856-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP 9011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.