Active NPI
John Nunn
- Physician Assistant
- Big Bear Lake, CA
National Provider Identifier
1689139057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA59140
- Practice address
- PO Box 1649
Big Bear Lake, CA 92315-1649 - Phone
- (619) 847-7741
- NPI assigned
- Feb 9, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA59140 | CA | Primary |
Addresses
Primary practice location
PO Box 1649
Big Bear Lake, CA 92315-1649
Mailing address
PO Box 1649
Big Bear Lake, CA 92315-1649
Phone (619) 847-7741
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
41949 Big Bear Blvd
Big Bear Lake, CA 92315
Phone (909) 878-3696
PO Box
Suite 1649
Big Bear Lake, CA 92315-1649
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA59140 | CA | MD | Physician Assistant |
Organizations & group practices 2
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.
-
- Long Term Care Pharmacy
- Big Bear Lake, CA
- NPI 1073553756
-
- Urgent Care Clinic/Center
- Big Bear Lake, CA
- NPI 1366104671
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Pharmacy
- Big Bear Lake, CA
- NPI 1073553756
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1689139057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1649",
"city": "BIG BEAR LAKE",
"state": "CA",
"postal_code": "923151649",
"telephone_number": "619-847-7741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 1649",
"city": "BIG BEAR LAKE",
"state": "CA",
"postal_code": "923151649",
"telephone_number": "619-847-7741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUNN",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-09",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA59140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Bear Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.