Active NPI
Jamie Michelle Wheelahan, NP
- Acute Care Nurse Practitioner
- Fairfield, CA
National Provider Identifier
1417915513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 17220
- Practice address
- 1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552 - Phone
- (707) 646-5300
- Fax
- (707) 646-5334
- NPI assigned
- May 1, 2006
- Last updated
- Jun 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 17220 | CA | Primary |
Addresses
Primary practice location
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Mailing address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 646-5300
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47037658373 | Medicaid | NE | |
| 17220 | Other | CA | LICENSE |
| 47078557542 | Medicaid | NE | |
| 110636 | Other | NE | LICENSE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creighton University | Past | Accepting new patients | |
| Creighton University | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Creighton Medical Associates
- Allergy & Immunology (Internal Medicine) Physician
- Omaha, NE
- NPI 1295777225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276473600000",
"number": "1417915513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 B GALE WILSON BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333552",
"telephone_number": "707-646-5300",
"fax_number": "707-646-5334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 B GALE WILSON BLVD",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333552",
"telephone_number": "707-646-5300",
"fax_number": "707-646-5334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELAHAN",
"first_name": "JAMIE",
"middle_name": "MICHELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-01",
"last_updated": "2010-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CA",
"license": "17220",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47037658373",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "17220",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47078557542",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "110636",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.