Individual provider Active NPI

Catherine Moreane Nickell

  • Family Nurse Practitioner
  • Bakersfield, CA
National Provider Identifier
1760193148
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030360 Issued in CA
Practice address
11901 Bolthouse Dr Ste 300
Bakersfield, CA 93311-8456
Phone
(661) 393-2331
NPI assigned
Dec 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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 95030360 CA Primary

Addresses

Primary practice location

11901 Bolthouse Dr Ste 300
Bakersfield, CA 93311-8456

Mailing address

11901 Bolthouse Dr Ste 300
Bakersfield, CA 93311-8456
Phone (661) 393-2331

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
I20250124000948 CA Practitioner - Nurse Practitioner 5294264958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sandeep S Walia, MD, a Professional Medical CorporationGroup PAC ID 2567893399, 5 clinicians
Kern County Hospital AuthorityGroup PAC ID 4688964521, 264 clinicians

Practice addresses (Care Compare)

215 China Grade Loop
Bakersfield, CA 93308-1707
Phone (661) 393-2331

2920 F St
Suite B1
Bakersfield, CA 93301-1829
Phone (661) 862-8175

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kern County Hospital Authority CurrentSince Oct 6, 2025 Accepting new patients
Kern County Hospital Authority CurrentSince Oct 6, 2025 Accepting new patients
Bakersfield Memorial Hospital PastSince Nov 10, 2024 Accepting new patients

Locations

2920 F St
Ste B1
Bakersfield, CA 93301
Phone (661) 862-8175

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1760193148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 BOLTHOUSE DR STE 300",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933118456",
            "telephone_number": "661-393-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 BOLTHOUSE DR STE 300",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933118456",
            "telephone_number": "661-393-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "CATHERINE",
        "middle_name": "MOREANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.