Individual provider Active NPI

Jeremiah E Stanley, NP

  • Family Nurse Practitioner
  • Paradise, CA
National Provider Identifier
1649508763
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19056 Issued in CA
Practice address
5974 Pentz Rd
Paradise, CA 95969-5509
Phone
(530) 877-9361
NPI assigned
Dec 1, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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 19056 CA Primary

Addresses

Primary practice location

5974 Pentz Rd
Paradise, CA 95969-5509

Mailing address

3082 McMurray Dr
Anderson, CA 96007-3544
Phone (530) 365-4420

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
I20100303000027 CA Practitioner - Nurse Practitioner 2163567116 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Medical Services IncGroup PAC ID 3678886231, 10 clinicians

Practice addresses (Care Compare)

3082 McMurray Dr
Anderson, CA 96007-3544
Phone (530) 365-4420

Hospital & facility affiliations

  • Aspire Home Healthcare of Northern California, Inc Home health agency, Yuba City, CA, CCN 059707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19056CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Mar 1, 2013 Accepting new patients
Cep America - California CurrentSince Mar 1, 2013 Accepting new patients
Cep America - California Current Accepting new patients
Orohealth Corporation a Non Profit Healthcare System PastSince Feb 25, 2012 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5974 Pentz Rd
Paradise, CA 95969
Phone (530) 872-2000

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 5

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 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": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1649508763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3082 MCMURRAY DR",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073544",
            "telephone_number": "530-365-4420",
            "fax_number": "530-365-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5974 PENTZ RD",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695509",
            "telephone_number": "530-877-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "JEREMIAH",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise, CA

Sources for this page

Verify at the official NPI Registry.