Individual provider Active NPI

Garrett Shriver, NP

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1114589363
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95012090 Issued in CA
Practice address
450 Bauchet St
Los Angeles, CA 90012-2907
Phone
(213) 473-6100
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95012090 CA Primary

Addresses

Primary practice location

450 Bauchet St
Los Angeles, CA 90012-2907

Mailing address

PO Box 1815
Huntington Beach, CA 92647-1815

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
I20220216002553 CA Practitioner - Nurse Practitioner 1658764576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Group,IncGroup PAC ID 4385883958, 54 clinicians

Practice addresses (Care Compare)

4955 Van Nuys Blvd
Suite 308
Sherman Oaks, CA 91403-1811
Phone (818) 528-1260

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Lynwood, CA, CCN 050104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Group,Inc CurrentSince Jan 10, 2022 Accepting new patients

Locations

501 W Glenoaks Blvd
Ste 26
Glendale, CA 91202

4940 Van Nuys Blvd
Ste 200
Sherman Oaks, CA 91403
Phone (818) 528-1222

4955 Van Nuys Blvd
Ste 308
Van Nuys, CA 91403
Phone (818) 387-6114

16850 Bear Valley Rd
Victorville, CA 92395
Phone (760) 241-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7032/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1114589363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1815",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926471815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BAUCHET ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122907",
            "telephone_number": "213-473-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRIVER",
        "first_name": "GARRETT",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.