Active NPI
Jonathan Davis Little, P.A.C.
- Physician Assistant
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122 - Phone
- (925) 939-3000
- NPI assigned
- May 27, 2014
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CA51678 | CA | |
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Mailing address
17 Hill Rd
South Hero, VT 05486-4113
Phone (802) 318-8831
Other practice location 1
1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 576-3883
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CA51678 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-California | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients |
Locations
1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
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.
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1396157236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 HILL RD",
"city": "SOUTH HERO",
"state": "VT",
"postal_code": "054864113",
"telephone_number": "802-318-8831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 YGNACIO VALLEY RD",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945983122",
"telephone_number": "925-939-3000"
}
],
"practiceLocations": [
{
"address_1": "1441 Florida Ave",
"address_purpose": "LOCATION",
"city": "Modesto",
"state": "CA",
"postal_code": "953504404",
"country_code": "US",
"telephone_number": "209-576-3883",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LITTLE",
"first_name": "JONATHAN",
"middle_name": "DAVIS",
"credential": "P.A.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-27",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "CA51678",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.