Individual provider Active NPI

Niji Justin Solomon, FNP

  • Family Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1912566456
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011506 Issued in CA
Practice address
2450 N Harbor Blvd Apt 12
Fullerton, CA 92835-2617
Phone
(714) 588-6443
NPI assigned
Jun 9, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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 95011506 CA Primary

Addresses

Primary practice location

2450 N Harbor Blvd Apt 12
Fullerton, CA 92835-2617

Mailing address

2450 N Harbor Blvd Apt 12
Fullerton, CA 92835-2617
Phone (714) 588-6443

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
I20200204002690 CA Practitioner - Nurse Practitioner 0143656413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95011506CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Cardiovascular Medical Group, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients

Locations

5945 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 323-4278

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1912566456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 N HARBOR BLVD APT 12",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352617",
            "telephone_number": "714-588-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 N HARBOR BLVD APT 12",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352617",
            "telephone_number": "714-588-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "NIJI",
        "middle_name": "JUSTIN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.