Individual provider Active NPI

Mary Ann Coverdell, RN APN

  • Family Nurse Practitioner
  • Citrus Heights, CA
National Provider Identifier
1609050681
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18626 Issued in CA
Practice address
7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133
Phone
(916) 536-3620
Fax
(916) 536-3541
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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 18626 CA Primary

Addresses

Primary practice location

7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956
Phone (916) 379-2726

Other identifiers 1

IdentifierTypeStateIssuer
160905681MedicaidCA

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
I20100113000845 CA Practitioner - Nurse Practitioner 6901975945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

6555 Coyle Ave
Carmichael, CA 95608-0302
Phone (916) 536-3540

Hospital & facility affiliations

  • Sonder Home Health Care Home health agency, Sacramento, CA, CCN 559201
  • Bellestar Home Health Care, Inc Home health agency, Folsom, CA, CCN 559061
  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
  • Mercy San Juan Medical Center Hospital, Carmichael, CA, CCN 050516

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18626CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Oct 16, 2015 Accepting new patients
Dignity Health Medical Foundation CurrentSince Oct 16, 2015 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

6555 Coyle Ave
Carmichael, CA 95608
Phone (916) 536-2500

7115 Greenback Ln
Fl 2
Citrus Heights, CA 95621
Phone (916) 536-3620

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1609050681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-379-2726",
            "fax_number": "916-853-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 GREENBACK LN",
            "address_2": "FL 2",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956216133",
            "telephone_number": "916-536-3620",
            "fax_number": "916-536-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERDELL",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160905681",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.