Medigrade LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

MEDIGRADE LLC

Practice address

1889 N Rice Ave Ste 201
Oxnard, CA 93030-7989

Phone

(833) 702-5508

NPI assigned

Sep 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Richard Heimann, MD

Title

Medical Director

Phone

(818) 371-9466

Specialties & licenses 1

Addresses

Other names 1

• ClubRxPro Doing business as

Locations

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1003634353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 COFFEEN AVE STE 4515",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015777",
            "telephone_number": "833-702-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1889 N RICE AVE STE 201",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930307989",
            "telephone_number": "833-702-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIGRADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "HEIMANN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-371-9466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ClubRxPro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trina Marie McPherson
• Mackenzie Nicole McSherry, BCBA
• Justine Meador, MSW, PHD
• Jimmy Meas, D.C.
• Medical Support Los Angeles a Medical Corporation
• Arantxa Medina-Alegria
• Alma Medina
• Claudia Cline Medina
• Joanna Medina, AMFT
• Matthew Medina, PT, DPT

• Preferred Provider Organization in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.