Individual provider Active NPI

Karen Anne Shadrick

  • Nurse Practitioner
  • Costa Mesa, CA
National Provider Identifier
1205322872
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95013316 Issued in CA
Practice address
150 Paularino Ave Ste D182
Costa Mesa, CA 92626-3302
Phone
(888) 336-3649
NPI assigned
Jul 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 700810 CA
Nurse Practitioner 363L00000X 95013316 CA Primary

Addresses

Primary practice location

150 Paularino Ave Ste D182
Costa Mesa, CA 92626-3302

Mailing address

2835 Ostrom Ave
Long Beach, CA 90815-1606
Phone (714) 747-6528

Other names 1

  • Karen Anne Lorenzo Former name

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
I20210513002358 CA Practitioner - Nurse Practitioner 4880003391 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
700810CAMDRegistered Nurse
95013316CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Sep 20, 2021 Accepting new patients
Global Transitional Care, LLC CurrentSince May 3, 2021 Accepting new patients
Pacific Shores Medical Group, Inc Current Accepting new patients
Pacific Shores Medical Group, Inc. CurrentSince Mar 25, 2021 Accepting new patients
Pacific Shores Medical Group, Inc. CurrentSince Mar 25, 2021 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

150 Paularino Ave
Ste D182
Costa Mesa, CA 92626
Phone (949) 668-2321

222 W Eulalia St
Ste 100B
Glendale, CA 91204
Phone (562) 430-5900

19582 Beach Blvd
Ste 212
Huntington Beach, CA 92648
Phone (714) 252-9415

5161 California Ave
Ste 200
Irvine, CA 92617
Phone (949) 543-0124

1043 Elm Ave
Ste 104
Long Beach, CA 90813
Phone (562) 495-6118

3747 Worsham Ave
Ste 101
Long Beach, CA 90808
Phone (562) 430-5900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1205322872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 OSTROM AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151606",
            "telephone_number": "714-747-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PAULARINO AVE STE D182",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263302",
            "telephone_number": "888-336-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADRICK",
        "first_name": "KAREN ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-07",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "700810",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95013316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN ANNE",
            "last_name": "LORENZO",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.