Individual provider Active NPI

Pamela Hughes, NP

  • Pediatric Nurse Practitioner
  • Riverside, CA
National Provider Identifier
1184015133
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP95001402 Issued in CA
Practice address
4440 Brockton Ave
Suite 420
Riverside, CA 92501-4068
Phone
(951) 684-8020
Fax
(951) 684-8090
NPI assigned
Feb 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP95001402 CA Primary

Addresses

Primary practice location

4440 Brockton Ave
Suite 420
Riverside, CA 92501-4068

Mailing address

29654 Dunkirk St
Sun City, CA 92586-3410
Phone (951) 684-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95001402CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mario Carcamo MD Inc Past Accepting new patients

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": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1184015133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29654 DUNKIRK ST",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925863410",
            "telephone_number": "951-684-8020",
            "fax_number": "951-684-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BROCKTON AVE",
            "address_2": "SUITE 420",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014068",
            "telephone_number": "951-684-8020",
            "fax_number": "951-684-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "PAMELA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95001402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.