Rachel Ann Ardoin, NP

Key facts

NPI

1124634563

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

95015034 (CA)

Practice address

11721 Telegraph Rd
Santa Fe Springs, CA 90670-3674

Phone

(562) 949-8455

NPI assigned

Sep 21, 2020

Sex

Female

Sole proprietor

Yes

Organizations & group practices 5

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.

• Pacific Clinics Community/Behavioral Health Agency · Campbell, CA · NPI 1255496105
  Medicare reassignment Care Compare group NPD CA
• Pacific Clinics Community/Behavioral Health Agency · Fresno, CA · NPI 1336458934
  NPD
• Pacific Clinics Community/Behavioral Health Agency · Monrovia, CA · NPI 1932866464
  NPD
• Revivex Healthcare Inc Non-Pharmacy Dispensing Site · Torrance, CA · NPI 1083087613
  NPD (past)
• Revivex Healthcare Inc Pain Medicine (Psychiatry & Neurology) Physician · Torrance, CA · NPI 1174800452
  NPD (past)

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Clinics (72 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2022.

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1124634563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 S CENTINELA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900664953",
            "telephone_number": "405-613-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDOIN",
        "first_name": "RACHEL",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95015034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Santa Fe Springs, CA · Nurse Practitioner in California