Individual provider Active NPI

Julie De Jesus

  • Family Nurse Practitioner
  • Ridgecrest, CA
National Provider Identifier
1588129183
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009965 Issued in CA
Practice address
1111 N China Lake Blvd Ste 190
Ridgecrest, CA 93555-3131
Phone
(760) 499-3855
Fax
(760) 499-3870
NPI assigned
Feb 7, 2019
Last updated
May 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009965 CA Primary

Addresses

Primary practice location

1111 N China Lake Blvd Ste 190
Ridgecrest, CA 93555-3131

Mailing address

1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 446-3800

Other identifiers 3

IdentifierTypeStateIssuer
95009965OtherCANURSE PRACTITIONER LICENSE
75022OtherCAREGISTERED NURSE LICENSE
95009965OtherCANURSE PRACTITIONER FURNISHING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address juliedejesus@rrh.medalliesdirect.net Direct

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
I20191106001581 CA Practitioner - Nurse Practitioner 2365774635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgecrest Regional HospitalGroup PAC ID 9739099896, 94 clinicians

Practice addresses (Care Compare)

1111 N China Lake Blvd
Ridgecrest, CA 93555-3131
Phone (760) 499-3855

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95009965CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgecrest Regional Hospital CurrentSince Aug 27, 2019 Accepting new patients
Ridgecrest Regional Hospital Single Specialty Current Accepting new patients
Ridgecrest Regional Hospital CurrentSince Aug 27, 2019 Accepting new patients

Locations

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

1111 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-4571

1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855

Interoperability endpoints

  • Direct secure messaging: juliedejesus@rrh.medalliesdirect.net

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.

Hospital & facility affiliations 2

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": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1588129183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553130",
            "telephone_number": "760-446-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N CHINA LAKE BLVD STE 190",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553131",
            "telephone_number": "760-499-3855",
            "fax_number": "760-499-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "95009965",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "75022",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER FURNISHING",
            "identifier": "95009965",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "juliedejesus@rrh.medalliesdirect.net",
            "affiliation": "N",
            "endpointDescription": "RRH Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1111 N China Lake Blvd Ste 190",
            "city": "Ridgecrest",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935553131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ridgecrest, CA

Sources for this page

Verify at the official NPI Registry.