Individual provider Active NPI

Taryl Lynn Nothern, NP

  • Nurse Practitioner
  • Anaheim Hills, CA
National Provider Identifier
1962773580
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8007 Issued in CA
Practice address
500 S Anaheim Hills Road
Suite 129
Anaheim Hills, CA 92807
Phone
(714) 282-1892
Fax
(714) 282-9682
NPI assigned
Jan 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 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 361783 CA
Nurse Practitioner 363L00000X 8007 CA Primary

Addresses

Primary practice location

500 S Anaheim Hills Road
Suite 129
Anaheim Hills, CA 92807

Mailing address

500 S Anaheim Hills Road
Suite 129
Anaheim Hills, CA 92807
Phone (714) 282-1892

Other practice location 1

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 282-1892

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tnothern1374107@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
I20210715003390 CA Practitioner - Nurse Practitioner 5597167353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
361783CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 10, 2021 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Apr 10, 2021 Accepting new patients
Janis D. Fee, MD, Inc Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

101 Laguna Rd
Ste 100
Fullerton, CA 92835

363 S Main St
Ste 345
Orange, CA 92868
Phone (714) 835-8715

2501 E Chapman Ave
Orange, CA 92869
Phone (714) 628-3300

Interoperability endpoints

  • Direct secure messaging: tnothern1374107@oc.providencedirect.org

Organizations & group practices 5

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": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1962773580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS ROAD",
            "address_2": "SUITE 129",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "92807",
            "telephone_number": "714-282-1892",
            "fax_number": "714-282-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S ANAHEIM HILLS ROAD",
            "address_2": "SUITE 129",
            "city": "ANAHEIM HILLS",
            "state": "CA",
            "postal_code": "92807",
            "telephone_number": "714-282-1892",
            "fax_number": "714-282-9682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 E Chapman Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928693204",
            "country_code": "US",
            "telephone_number": "714-282-1892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOTHERN",
        "first_name": "TARYL",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-13",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "361783",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "8007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnothern1374107@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2501 E Chapman Ave",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928693204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaheim Hills, CA

Sources for this page

Verify at the official NPI Registry.