Individual provider Active NPI

Gina Othea Harrell

  • Administrator Registered Nurse
  • Woodland, CA
National Provider Identifier
1699847681
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
514741 Issued in CA
Practice address
825 East St
Suite 302
Woodland, CA 95776-4976
Phone
(530) 402-2800
Fax
(530) 402-2809
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 514741 CA Primary

Addresses

Primary practice location

825 East St
Suite 302
Woodland, CA 95776-4976

Mailing address

200 Dragonfly Cir
Sacramento, CA 95834-2611
Phone (916) 928-9132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
514741CAMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699847681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DRAGONFLY CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958342611",
            "telephone_number": "916-928-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EAST ST",
            "address_2": "SUITE 302",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957764976",
            "telephone_number": "530-402-2800",
            "fax_number": "530-402-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "GINA",
        "middle_name": "OTHEA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "514741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.