Individual provider Active NPI

Karen G Chase, FNP RN

  • Nurse Practitioner
  • Fortuna, CA
National Provider Identifier
1891729406
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
FNP22744 Issued in CA
Practice address
3304 Renner Dr
Fortuna, CA 95540-7102
Phone
(707) 725-4477
Fax
(707) 725-9209
NPI assigned
Jul 10, 2006
Last updated
Aug 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1101505 VA
Nurse Practitioner 363L00000X 4066P KY
Family Nurse Practitioner 363LF0000X 0024165295 VA
Nurse Practitioner 363L00000X FNP22744 CA Primary

Addresses

Primary practice location

3304 Renner Dr
Fortuna, CA 95540-7102

Mailing address

670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633

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
I20181116000431 CA Practitioner - Nurse Practitioner 8820991755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Sutter Coast HospitalGroup PAC ID 9436148111, 29 clinicians

Practice addresses (Care Compare)

780 E Washington Blvd
Crescent City, CA 95531-8397
Phone (707) 464-6715

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.99 of 100Reported as group
Quality
57.99
Promoting interoperability
100
Improvement activities
40
Cost
72.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1101505VAMDRegistered Nurse
FNP22744CAMDNurse Practitioner
4066PKYMDNurse Practitioner
0024165295VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Coast Hospital CurrentSince Sep 24, 2014 Accepting new patients
Sutter Coast Hospital CurrentSince Sep 24, 2014 Accepting new patients
Sutter Coast Hospital Past Accepting new patients
Sutter Coast Hospital Past Accepting new patients

Locations

780 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-5974

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

Interoperability endpoints

  • Direct secure messaging: kchase262226@hisp.ehr.sutterhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1891729406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955407102",
            "telephone_number": "707-725-4477",
            "fax_number": "707-725-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "KAREN",
        "middle_name": "G",
        "credential": "FNP RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "1101505",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4066P",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024165295",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "FNP22744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

Verify at the official NPI Registry.