Individual provider Active NPI

Rita Alicia Shirey, RN NP

  • Adult Health Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1366598633
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN257179 Issued in CA
Practice address
651 Wake Ave
Suite B
El Centro, CA 92243-9490
Phone
(760) 352-2257
Fax
(760) 352-7853
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN257179 CA Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN257179 CA

Addresses

Primary practice location

651 Wake Ave
Suite B
El Centro, CA 92243-9490

Mailing address

PO Box 628
Seeley, CA 92273-0628
Phone (760) 352-3304

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN257179CAMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1366598633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "SEELEY",
            "state": "CA",
            "postal_code": "922730628",
            "telephone_number": "760-352-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 WAKE AVE",
            "address_2": "SUITE B",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922439490",
            "telephone_number": "760-352-2257",
            "fax_number": "760-352-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIREY",
        "first_name": "RITA",
        "middle_name": "ALICIA",
        "credential": "RN NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "RN257179",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "RN257179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.