Individual provider Active NPI

Sharine Forbes, DOCTORAL NP

  • Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1174165039
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95033040 Issued in CA
Practice address
4425 S Central Ave
Los Angeles, CA 90011-3629
Phone
(323) 908-4200
Fax
(323) 985-9940
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 95033040 CA Primary

Addresses

Primary practice location

4425 S Central Ave
Los Angeles, CA 90011-3629

Mailing address

4425 S Central Ave
Los Angeles, CA 90011-3629
Phone (323) 908-4200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sforbes@wellchild.org

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
I20260220001042 CA Order and Referring Only - Nurse Practitioner 1658852439

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95033040CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apla Health & Wellness Multi-Specialty Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: sharine.forbes.p1@direct.scfhc.nextgenshare.com

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": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1174165039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200",
            "fax_number": "323-985-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200",
            "fax_number": "323-985-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "SHARINE",
        "credential": "DOCTORAL NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95033040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sforbes@wellchild.org",
            "affiliation": "N",
            "address_1": "808 W 58th St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900373632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.