NPIMap

Organization Active NPI

Community Foundation Medical Group

  • Internal Medicine Physician
  • Fresno, CA
National Provider Identifier
1003329491
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COMMUNITY FOUNDATION MEDICAL GROUP
Practice address
7370 N Palm Ave Ste 101
Fresno, CA 93711-5782
Phone
(559) 228-5400
NPI assigned
Nov 8, 2017
Organization subpart
Yes
Parent organization
COMMUNITY FOUNDATION MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Authorized official

Name
Mr. Scott B Wells
Title
Ceo/President
Phone
(559) 228-5429

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gynecologic Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0201X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

7370 N Palm Ave Ste 101
Fresno, CA 93711-5782

Mailing address

PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-5400

Other names 1

  • Sante' Foundation Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000387 CA Part B Supplier - Clinic/Group Practice 0345406294 Receives reassigned benefits from 553 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Community FDTN Med GRP

Locations

7235 N 1st St
Ste 103
Fresno, CA 93720
Phone (559) 432-2600

560 E Herndon Ave
Ste 201
Fresno, CA 93720
Phone (559) 437-7311

540 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 442-0855

1660 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 431-4204

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 129

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

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1003329491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298949",
            "telephone_number": "559-228-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 N PALM AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115782",
            "telephone_number": "559-228-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY FOUNDATION MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY FOUNDATION MEDICAL GROUP",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "559-228-5429",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sante' Foundation Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sante' Foundation Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.