Individual provider Active NPI

Shantel Nicole Joling, PA-C

  • Medical Physician Assistant
  • Yreka, CA
National Provider Identifier
1659605327
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20553 Issued in CA
Practice address
475 Bruce St
Yreka, CA 96097-3474
Phone
(530) 842-3507
Fax
(530) 842-9412
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20553 CA Primary

Addresses

Primary practice location

475 Bruce St
Yreka, CA 96097-3474

Mailing address

475 Bruce St
Yreka, CA 96097-3474
Phone (530) 842-3507

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
I20100216000733 CA Practitioner - Physician Assistant 2961546809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, Davis School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siskiyou Hospital IncGroup PAC ID 1254223134, 96 clinicians

Practice addresses (Care Compare)

444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121

475 Bruce St
Yreka, CA 96097-3474
Phone (530) 842-4121

Hospital & facility affiliations

  • Fairchild Medical Center Hospital, Yreka, CA, CCN 051316
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20553CAMDPediatric Occupational Therapist
PA20553CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Siskiyou Hospital, Inc. CurrentSince Nov 20, 2013 Accepting new patients

Locations

408 Pine St
Mount Shasta, CA 96067
Phone (530) 926-3222

475 Bruce St
Yreka, CA 96097
Phone (530) 842-3507

444 Bruce St
Yreka, CA 96097
Phone (530) 841-6256

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.

Hospital & facility affiliations 3

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": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1659605327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-3507",
            "fax_number": "530-842-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BRUCE ST",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973474",
            "telephone_number": "530-842-3507",
            "fax_number": "530-842-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLING",
        "first_name": "SHANTEL",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yreka, CA

Sources for this page

Verify at the official NPI Registry.