Individual provider Active NPI

Shelley Nicole Howell, PA

  • Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1215209770
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA22085 Issued in CA
Practice address
11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055
Phone
(714) 850-7300
Fax
(714) 850-7310
NPI assigned
Jan 31, 2012
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA22085 CA Primary

Addresses

Primary practice location

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055

Mailing address

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055
Phone (714) 850-7300

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22085CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Payam Farjoodi MD Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Orthowest Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1327968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1215209770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055",
            "telephone_number": "714-850-7300",
            "fax_number": "714-850-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055",
            "telephone_number": "714-850-7300",
            "fax_number": "714-850-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "SHELLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-31",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.