Individual provider Active NPI

Stella Nwasoka Adesokan

  • Family Nurse Practitioner
  • Merced, CA
National Provider Identifier
1114392990
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003522 Issued in CA
Practice address
1114 Olivewood Dr
Merced, CA 95348-1210
Phone
(209) 349-1896
NPI assigned
Dec 5, 2015
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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 95003522 CA Primary

Addresses

Primary practice location

1114 Olivewood Dr
Merced, CA 95348-1210

Mailing address

1114 Olivewood Drive
Mered, CA 93637-8649
Phone (209) 349-1896

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
I20161114000906 CA Practitioner - Nurse Practitioner 0547553455 Practice locations: Dos Palos, CA; Merced, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2142 Marguerite St
Dos Palos, CA 93620-2351
Phone (209) 364-5955

780 W Olive Ave
Suite 104
Merced, CA 95348-2437
Phone (209) 575-4575

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003522CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maniberry Healthcare Services PastSince Sep 21, 2016 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1449273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1114392990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 OLIVEWOOD DRIVE",
            "city": "MERED",
            "state": "CA",
            "postal_code": "936378649",
            "telephone_number": "209-349-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 OLIVEWOOD DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481210",
            "telephone_number": "209-349-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADESOKAN",
        "first_name": "STELLA",
        "middle_name": "NWASOKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-05",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.