Active NPI
Adam Michael Shults, PA-C
- Physician Assistant
- San Diego, CA
National Provider Identifier
1093088205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA57151
- Practice address
- 2051 Cushing Rd
San Diego, CA 92106-6173 - Phone
- (619) 881-9001
- NPI assigned
- Feb 17, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA57151 | CA | Primary |
Addresses
Primary practice location
2051 Cushing Rd
San Diego, CA 92106-6173
Mailing address
2051 Cushing Rd
San Diego, CA 92106-6173
Phone (619) 881-9001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57151 | CA | MD | Marriage & Family Therapist |
| PA57151 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Somagen Healthcare Inc | Single Specialty | Past | Accepting new patients |
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": "1329436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566864000000",
"number": "1093088205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2051 CUSHING RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921066173",
"telephone_number": "619-881-9001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 CUSHING RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921066173",
"telephone_number": "619-881-9001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULTS",
"first_name": "ADAM",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-17",
"last_updated": "2019-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA57151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.