Jill Antell, WHNP
Individual provider Active NPI Obstetrics & Gynecology Nurse Practitioner · Paradise, CA
NPI 1720104649 · NPPES record last updated Aug 11, 2023
Key facts
- NPI
- 1720104649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner 363LX0001X
- License
- 825017 (NV)
- Practice address
- 6283 Clark Rd Ste 5
Paradise, CA 95969-4100 - Phone
- (530) 872-2000
- Fax
- (530) 332-1049
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.77 of 100
- Quality
- 81.54
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NV, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191121002017 | NV | Practitioner - Nurse Practitioner | 6901067578 | Reassigns benefits to 2 organizations |
| I20230831002576 | CA | Practitioner - Nurse Practitioner | 6901067578 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 178779 | CO | MD | Nurse Practitioner |
| TRN170433 | AZ | MD | Obstetrics & Gynecology Nurse Practitioner |
| NP95026011 | CA | MD | Obstetrics & Gynecology Nurse Practitioner |
| 825017 | NV | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Group Rhodes P C | Current | Accepting new patients | |
| Optum Medical Group II Rhodes P C | Current |
Accepting new patients | |
| Southwest Medical Associates, Inc | Current |
Accepting new patients | |
| Adventist Health Clearlake Hospital Inc. | Current |
Accepting new patients | |
| Las Vegas Urology LLP | Past |
Accepting new patients |
Locations
15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820
5125 Skyway
Paradise, CA 95969
Phone (530) 872-2000
2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500
420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710
2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN 178779 | CO | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | TRN170433 | AZ | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | NP95026011 | CA | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 825017 | NV | Yes |
Addresses
Primary practice location
6283 Clark Rd Ste 5
Paradise, CA 95969-4100
Mailing address
6283 Clark Rd Ste 5
Paradise, CA 95969-4100
Phone (530) 872-2000
Other names
- Jill Tunnell
Other providers in Paradise, CA
- Brittany Ann Anderson
- Deborah June Anderson
- Sarah D. Anderson
- Tsion Zenani Anderson
- Ann K. McPherran, O.D.
- Angela Marie Apodaca
- Dennis Lee Armstrong
- Matthew James Armstrong
- Cynthia Elizabeth Arrington
- Alexandria Anoush Ashkarian
All providers in Paradise, CA · Obstetrics & Gynecology Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.