Individual provider Active NPI

Mikell Angela Schlumpf, PA-C

  • Physician Assistant
  • Colton, CA
National Provider Identifier
1659801975
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
54641 Issued in CA
Practice address
400 N Pepper Ave Ste 2Mob206
Colton, CA 92324-1801
Phone
(909) 580-3474
Fax
(909) 580-3289
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 54641 CA Primary

Addresses

Primary practice location

400 N Pepper Ave Ste 2Mob206
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Colton, CA 92324-1801

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
I20181215000527 CA Practitioner - Physician Assistant 2365787538 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54641CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Oct 22, 2018 Accepting new patients
St. Johns Community Health CurrentSince Oct 22, 2018 Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

Interoperability endpoints

  • Direct secure messaging: mikell.schlumpf.p6@direct.mpmccorp.nextgenshare.com
  • Direct secure messaging: mikell.schlumpf.p2@direct.mpmccorp.nextgenshare.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1659801975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE STE 2MOB206",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-3474",
            "fax_number": "909-580-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUMPF",
        "first_name": "MIKELL",
        "middle_name": "ANGELA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.