Individual provider Active NPI

Heather Lynn McIsaac, AGACNP-BC, APRN

  • Acute Care Nurse Practitioner
  • Fountain Valley, CA
National Provider Identifier
1861022824
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP95012327 Issued in CA
Practice address
11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505
Phone
(714) 241-9200
NPI assigned
Jan 17, 2020
Last updated
Jan 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP95012327 CA Primary

Addresses

Primary practice location

11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505

Mailing address

16722 Ross LN
Huntington Beach, CA 92647-5019
Phone (714) 454-7155

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
I20231213003963 CA Practitioner - Nurse Practitioner 4981053006 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95012327CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Independent Physicians Association Inc CurrentSince Sep 10, 2023 Accepting new patients
CM Providers Medical Group, PC CurrentSince Aug 29, 2023 Accepting new patients

Locations

11180 Warner Ave
Ste 463
Fountain Vly, CA 92708
Phone (714) 241-9200

1501 Superior Ave
Ste 205
Newport Beach, CA 92663
Phone (866) 433-9943

625 The City Dr S
Ste 310
Orange, CA 92868
Phone (949) 674-1548

Organizations & group practices 2

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": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1861022824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16722 ROSS LN",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926475019",
            "telephone_number": "714-454-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "credential": "AGACNP-BC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP95012327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.