Individual provider Active NPI

Shemika D. Carter, NURSE PRACTITIONER

  • Primary Care Nurse Practitioner
  • Walnut, CA
National Provider Identifier
1538635693
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95011052 Issued in CA
Practice address
20709 Golden Springs Dr Ste 106
Walnut, CA 91789-3847
Phone
(844) 938-2828
Fax
(866) 473-3822
NPI assigned
Oct 16, 2018
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95011052 CA Primary

Addresses

Primary practice location

20709 Golden Springs Dr Ste 106
Walnut, CA 91789-3847

Mailing address

20709 Golden Springs Dr Ste 106
Walnut, CA 91789-3847
Phone (844) 938-2828

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603001177 CA Practitioner - Nurse Practitioner 7214260405 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Home Foot Care IncGroup PAC ID 4981744257, 25 clinicians
Altea Medical California PCGroup PAC ID 1850740150, 84 clinicians

Practice addresses (Care Compare)

Walnut, CA 91789
Phone (323) 388-6575

12520 Magnolia Blvd
Suite 304
Valley Village, CA 91607-2355
Phone (818) 452-9902

1425 Laurel Ave
Pomona, CA 91768-2837
Phone (909) 622-1069

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael D. Kotzen, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Home Foot Care, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Trucare Telehealth Medical Group Primary Care CurrentSince Feb 26, 2021 Accepting new patients

Locations

3756 Santa Rosalia Dr
Ste 100
Los Angeles, CA 90008
Phone (323) 294-7517

4193 Flat Rock Dr
Ste 216
Riverside, CA 92505
Phone (951) 405-0444

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

20709 Golden Springs Dr
Ste 106
Walnut, CA 91789
Phone (323) 388-6575

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1538635693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20709 GOLDEN SPRINGS DR STE 106",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893847",
            "telephone_number": "844-938-2828",
            "fax_number": "866-473-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20709 GOLDEN SPRINGS DR STE 106",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893847",
            "telephone_number": "844-938-2828",
            "fax_number": "866-473-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "SHEMIKA",
        "middle_name": "D.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95011052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, CA

Sources for this page

Verify at the official NPI Registry.