Jackline Shinyonya Sutherland, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95011529 Issued in CA

Practice address

320 E Palmdale Blvd
Palmdale, CA 93550-4598

Phone

(661) 526-4766

NPI assigned

Jan 27, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

High Desert Medical CorporationGroup PAC ID 6103730569, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jacklineshinyonya.sutherland@direct.hdmg.nextgenshare.com

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.

• High Desert Medical Group

  • Multi-Specialty Clinic/Center
  • Lancaster, CA
  • NPI 1720196702
  Medicare reassignment Care Compare group NPD
• Health and Wellness Telemedicine

  • Family Nurse Practitioner
  • Palmdale, CA
  • NPI 1558216838
  NPD Authorized official

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1861882029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 TOURNAMENT DR",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935515635",
            "telephone_number": "661-526-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504598",
            "telephone_number": "661-526-4766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "907 W Lancaster Blvd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "CA",
            "postal_code": "935342305",
            "country_code": "US",
            "telephone_number": "818-654-3887",
            "fax_number": "818-975-5061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "JACKLINE",
        "middle_name": "SHINYONYA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 3442",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R2068891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1537966505",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Sulitzer, DMD
• Summit Medical Group
• Summit Medical Partners
• Ma Therese Sunga Sunga
• Shirley Surrao, NP
• Cheryl Ann Swanson, L.C.S.W.
• Justin Swayne, LVN
• Kathleen Ann Sweeney
• Alice Sweet
• Princess Alexandra Sylve

• Family Nurse Practitioner in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.