Active NPI
Orcutt Direct Care an Advanced Practice Nursing Corp
- Primary Care Nurse Practitioner
- Orcutt, CA
National Provider Identifier
1316639107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- ORCUTT DIRECT CARE AN ADVANCED PRACTICE NURSING CORP
- Practice address
- 1145 E Clark Ave Ste C
Orcutt, CA 93455-5151 - Phone
- (805) 270-5020
- NPI assigned
- May 22, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alex Schroeder, RN
- Title
- President
- Phone
- (805) 270-5020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
1145 E Clark Ave Ste C
Orcutt, CA 93455-5151
Mailing address
1145 E Clark Ave Ste C
Orcutt, CA 93455-5151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240112000184 | CA | Part B Supplier - Clinic/Group Practice | 6305297599 |
Receives reassigned benefits from 1 practitioner Practice locations: Orcutt, CA |
National Provider Directory
National Provider DirectoryPractitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684713600000",
"number": "1316639107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 E CLARK AVE STE C",
"city": "ORCUTT",
"state": "CA",
"postal_code": "934555151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 E CLARK AVE STE C",
"city": "ORCUTT",
"state": "CA",
"postal_code": "934555151",
"telephone_number": "805-270-5020"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORCUTT DIRECT CARE AN ADVANCED PRACTICE NURSING CORP",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A",
"authorized_official_last_name": "SCHROEDER",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "805-270-5020",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orcutt, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.