Individual provider Active NPI

Steven Shirley, NP

  • Gerontology Nurse Practitioner
  • Delano, CA
National Provider Identifier
1629665203
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95016268 Issued in CA
Practice address
1425 Main St
Delano, CA 93215-1726
Phone
(661) 778-0920
Fax
(661) 778-0919
NPI assigned
Dec 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95016268 CA Primary

Addresses

Primary practice location

1425 Main St
Delano, CA 93215-1726

Mailing address

231 W Noble Ave
Visalia, CA 93277-2631
Phone (559) 635-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230118002427 WA Practitioner - Nurse Practitioner 7113398736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Rehabilitation Physicians LLCGroup PAC ID 7214334614, 44 clinicians

Practice addresses (Care Compare)

2508 7TH St SE
Puyallup, WA 98374-1105
Phone (801) 215-9309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016268CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Rehabilitation Physicians LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

2508 7th St SE
Puyallup, WA 98374
Phone (253) 841-6600

4430 Talbot Rd S
Renton, WA 98055
Phone (425) 226-7500

Organizations & group practices 1

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": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1629665203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 W NOBLE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932772631",
            "telephone_number": "559-635-7100",
            "fax_number": "559-635-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MAIN ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151726",
            "telephone_number": "661-778-0920",
            "fax_number": "661-778-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "STEVEN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95016268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delano, CA

Sources for this page

Verify at the official NPI Registry.