Individual provider Active NPI

Rose Kim Chang Hull, NP

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1174811046
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP20843 Issued in CA
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 499-6439
Fax
(559) 499-6441
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN718940 CA
Nurse Practitioner 363L00000X NP20843 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230-5990
Phone (559) 537-0305

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
I20110913000745 CA Practitioner - Nurse Practitioner 6103097613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

1524 W Lacey Blvd
Suite 105
Hanford, CA 93230-5968
Phone (559) 583-4506

Hospital & facility affiliations

  • Adventist Health Home Care Services Home health agency, Hanford, CA, CCN 057477
  • Adventist Health Hanford Hospital, Hanford, CA, CCN 050121

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN718940CAMDRegistered Nurse
NP20843CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Jun 8, 2015 Accepting new patients
Adventist Health Physicians Network CurrentSince Jun 8, 2015 Accepting new patients
Central California Faculty Medical Group, Inc. Past Accepting new patients

Locations

1524 W Lacey Blvd
Ste 101
Hanford, CA 93230
Phone (559) 583-4695

1524 W Lacey Blvd
Ste 105
Hanford, CA 93230
Phone (559) 537-0405

Organizations & group practices 3

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 2

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1174811046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 W LACEY BLVD",
            "address_2": "STE 101",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932305990",
            "telephone_number": "559-537-0305",
            "fax_number": "559-537-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-499-6439",
            "fax_number": "559-499-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG HULL",
        "first_name": "ROSE",
        "middle_name": "KIM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN718940",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP20843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.