Individual provider Active NPI

Jill Olmstead, N.P.

  • Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1740276732
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP8926 Issued in CA
Practice address
1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone
(714) 446-5831
NPI assigned
Sep 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP8926 CA Primary

Addresses

Primary practice location

1837 Sunny Crest Dr
Fullerton, CA 92835-3616

Mailing address

1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5831

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jolmstead1045217@oc.providencedirect.org

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
I20051115000649 CA Practitioner - Nurse Practitioner 9830118231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1835 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5101

1837 Sunny Crest Dr
Fullerton, CA 92835-3616
Phone (714) 446-5831

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

253 S Diamond Bar Blvd
Diamond Bar, CA 91765-1606
Phone (909) 860-1144

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP8926CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Feb 22, 2010 Accepting new patients
Providence Medical Foundation CurrentSince Feb 22, 2010 Accepting new patients
Providence Medical Foundation Current Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

1837 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5831

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

433 W Bastanchury Rd
Fullerton, CA 92835
Phone (714) 446-7800

4300 Rose Dr
Yorba Linda, CA 92886
Phone (714) 528-4211

Interoperability endpoints

  • Direct secure messaging: jolmstead1045217@oc.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1740276732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831",
            "fax_number": "714-446-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 SUNNY CREST DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353616",
            "telephone_number": "714-446-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMSTEAD",
        "first_name": "JILL",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP8926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jolmstead1045217@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1837 Sunny Crest Dr",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.