Individual provider Active NPI

Yardana Gill, FNP

  • Nurse Practitioner
  • Travis Afb, CA
National Provider Identifier
1154789154
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95003716 Issued in CA
Practice address
101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809
Phone
(707) 423-2300
Fax
(707) 423-3357
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 95003716 CA Primary

Addresses

Primary practice location

101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809

Mailing address

101 Bodin Cir BLDG 777
Travis Afb, CA 94535-1809
Phone (707) 423-2300

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
I20170126002402 CA Practitioner - Nurse Practitioner 3173805132 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northbay Healthcare Group CurrentSince Nov 29, 2016 Accepting new patients
Northbay Healthcare Group CurrentSince Nov 29, 2016 Accepting new patients

Locations

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

1860 Pennsylvania Ave
Ste 110
Fairfield, CA 94533
Phone (707) 254-9693

1860 Pennsylvania Ave
Ste 120
Fairfield, CA 94533
Phone (707) 426-4696

101 Bodin Cir
Bldg 777
Travis AFB, CA 94535
Phone (707) 423-2388

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

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": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1154789154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-2300",
            "fax_number": "707-423-3357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR BLDG 777",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-2300",
            "fax_number": "707-423-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "YARDANA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis Afb, CA

Sources for this page

Verify at the official NPI Registry.