NPIMap

Organization Active NPI

Gettysburg Medical Clinic, Inc.

  • Multi-Specialty Clinic/Center
  • Merced, CA
National Provider Identifier
1023116589
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GETTYSBURG MEDICAL CLINIC, INC.
Practice address
143 W Main St
Merced, CA 95340-4930
Phone
(209) 725-2060
Fax
(209) 725-2072
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Grace Wee Lim, M.D.NPI 1437256211
Title
President
Phone
(559) 244-6360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

143 W Main St
Merced, CA 95340-4930

Mailing address

143 W Main St
Merced, CA 95340-4930
Phone (209) 725-2060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121128000353 CA Part B Supplier - Clinic/Group Practice 5991957805 Receives reassigned benefits from 5 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Modesto, CA; Merced, CA; Fresno, CA; Atwater, CA

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0945143Gettysburg Medical Clinic Inc143 W Main St, #B, Merced, CA 95340Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gettysburg Medical Clinic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5088 N Fresno St
Ste B
Fresno, CA 93710

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023116589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 W MAIN ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953404930",
            "telephone_number": "209-725-2060",
            "fax_number": "209-725-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 W MAIN ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953404930",
            "telephone_number": "209-725-2060",
            "fax_number": "209-725-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GETTYSBURG MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "WEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-244-6360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.