Individual provider Active NPI

Shelli Dawn Chittum, NP

  • Nurse Practitioner
  • Stanford, CA
National Provider Identifier
1932565322
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95003729 Issued in CA
Practice address
300 Pasteur Dr RM A301
Stanford, CA 94305-2200
Phone
(650) 723-6469
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN644118 CA
Nurse Practitioner 363L00000X NP95003729 CA Primary

Addresses

Primary practice location

300 Pasteur Dr RM A301
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr RM A301
Stanford, CA 94305-2200
Phone (650) 723-6469

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address schittum824747@oc.providencedirect.org

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
I20160526002520 CA Practitioner - Nurse Practitioner 4183914476 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN644118CAMDRegistered Nurse
NP95003729CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince May 28, 2019 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 21, 2019 Accepting new patients
Regents of the Univ of Ca CurrentSince Mar 21, 2019 Accepting new patients
Stanford Health Care Current Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince May 28, 2019 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Providence Saint Johns Medical Foundation CurrentSince Jul 1, 2018 Accepting new patients
Stanford Health Care CurrentSince May 28, 2019 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Providence Saint John'S Health Center Past Accepting new patients

Locations

12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

3160 Folsom Blvd
Ste 3900
Sacramento, CA 95816
Phone (916) 734-3658

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2125 Arizona Ave
Santa Monica, CA 90404
Phone (310) 582-7450

300 Pasteur Dr
Rm A301
Stanford, CA 94305
Phone (650) 723-6469

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

11645 Wilshire Blvd
Ste 600
West Los Angeles, CA 90025
Phone (310) 477-5558

Interoperability endpoints

  • Direct secure messaging: schittum824747@oc.providencedirect.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1932565322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR RM A301",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR RM A301",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITTUM",
        "first_name": "SHELLI",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN644118",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95003729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "schittum824747@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2125 Arizona Ave",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904041337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.