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Adventist Health Physicians Network

Organization Active NPI Internal Medicine Physician · Saint Helena, CA

NPI 1003113192 · NPPES record last updated Feb 25, 2011

Key facts

NPI
1003113192
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
ADVENTIST HEALTH PHYSICIANS NETWORK
Practice address
6 Woodland Rd
Suite 102
Saint Helena, CA 94574-9501
Phone
(707) 963-8842
Fax
(707) 963-3713
NPI assigned
Feb 25, 2011
Organization subpart
Yes
Parent organization (as reported)
ADVENTIST HEALTH PHYSICIANS NETWORK

Authorized official

Name
Mr. Jeff Conklin
Title
President
Phone
(916) 789-4209

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050407000633 CA Part B Supplier - Clinic/Group Practice 3274580972 Receives reassigned benefits from 808 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Part of
Clafiornia Med FD

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD
    Plans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207R00000X Yes

Addresses

Primary practice location

6 Woodland Rd
Suite 102
Saint Helena, CA 94574-9501

Mailing address

1001 Adams St
Saint Helena, CA 94574-1107
Phone (707) 968-2865

Other names

  • St. Helena Internal Medicine Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 25, 2011.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1003113192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ADAMS ST",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945741107",
            "telephone_number": "707-968-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "address_2": "SUITE 102",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749501",
            "telephone_number": "707-963-8842",
            "fax_number": "707-963-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-789-4209",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Helena Internal Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Helena, CA

All providers in Saint Helena, CA · Internal Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.