Individual provider Active NPI

Jill R Richert, NP

  • Family Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1710182993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14595 Issued in CA
Practice address
1555 Higuera St
San Luis Obispo, CA 93401-2917
Phone
(805) 543-2324
NPI assigned
Jun 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Family Nurse Practitioner 363LF0000X 14595 CA Primary

Addresses

Primary practice location

1555 Higuera St
San Luis Obispo, CA 93401-2917

Mailing address

541 Caudill St
San Luis Obispo, CA 93401-5658

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
I20140724000238 CA Practitioner - Nurse Practitioner 1850517038 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14595CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc Current Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jun 16, 2014 Accepting new patients
Community Health Centers of the Central Coast Inc CurrentSince Jun 16, 2014 Accepting new patients

Locations

1057 E Grand Ave
Arroyo Grande, CA 93420
Phone (805) 270-1700

150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254

2801 Santa Maria Way
Bldg A
Santa Maria, CA 93455
Phone (805) 938-9200

325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644

Interoperability endpoints

  • Direct secure messaging: jill.richert.1@17363.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710182993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 CAUDILL ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 HIGUERA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012917",
            "telephone_number": "805-543-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERT",
        "first_name": "JILL",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "14595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.