Individual provider Active NPI

Rachel Rene Stockwell, NP

  • Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1487938122
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95011496 Issued in CA
Practice address
724 S El Camino Real
San Clemente, CA 92672-4250
Phone
(949) 493-6113
Fax
(949) 493-5851
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 65980 OK
Adult Health Nurse Practitioner 363LA2200X 209-008986 IL
Nurse Practitioner 363L00000X 95011496 CA Primary

Addresses

Primary practice location

724 S El Camino Real
San Clemente, CA 92672-4250

Mailing address

11 Technology Dr
Irvine, CA 92618-2302

Other practice location 1

1265 S Utica Ave Ste 300
Tulsa, OK 74104
Phone (918) 592-0999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171205003489 OK Practitioner - Nurse Practitioner 0840465829 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4964WIMDGeneral Practice Dentistry
95011496CAMDNurse Practitioner
65980OKMDNurse Practitioner
209-008986ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Heart LLC CurrentSince Nov 15, 2017 Accepting new patients
Omni Medical Group Inc CurrentSince Aug 6, 2018 Accepting new patients
Midwest Palliative & Hospice Carecenter Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Locations

Dept 1218
Tulsa, OK 74182

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

4720 S Harvard Ave
Ste 100
Tulsa, OK 74135
Phone (918) 749-6730

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 855-2570

Interoperability endpoints

  • Direct secure messaging: rachel.stockwell.p7@direct.monarchhealthcare.nextgenshare.com
  • Direct secure messaging: rstockwell112810@ahs.direct-ci.com
  • Direct secure messaging: rstockwell607108@direct.memorialcare.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1487938122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TECHNOLOGY DR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 S EL CAMINO REAL",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724250",
            "telephone_number": "949-493-6113",
            "fax_number": "949-493-5851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1265 S Utica Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74104",
            "country_code": "US",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "RACHEL",
        "middle_name": "RENE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "65980",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-008986",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.