Individual provider Active NPI

Jacob Stults, DO

  • Student in an Organized Health Care Education/Training Program
  • Ukiah, CA
National Provider Identifier
1932901352
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
260 Hospital Dr Ste 103
Ukiah, CA 95482-4568
Phone
(707) 467-3123
NPI assigned
Mar 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

260 Hospital Dr Ste 103
Ukiah, CA 95482-4568

Mailing address

260 Hospital Dr Ste 101
Ukiah, CA 95482-4568

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260316000186 CA Practitioner - Family Practice 3678056975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukiah Adventist HospitalGroup PAC ID 6406816123, 136 clinicians

Practice addresses (Care Compare)

260 Hospital Dr
Ukiah, CA 95482-4568

Hospital & facility affiliations

  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
  • Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4915CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ukiah Adventist Hospital CurrentSince Jan 1, 2026 Accepting new patients
Ukiah Adventist Hospital CurrentSince Jan 1, 2026 Accepting new patients

Locations

260 Hospital Dr
Ste 207
Ukiah, CA 95482
Phone (707) 463-7627

260 Hospital Dr
Ste 101
Ukiah, CA 95482
Phone (707) 463-7428

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

260 Hospital Dr
Ste 103
Ukiah, CA 95482
Phone (707) 463-7490

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.

Hospital & facility affiliations 2

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": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1932901352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 101",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 103",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-467-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTS",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.