Sutter Medical Group of the Redwoods

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUTTER MEDICAL GROUP OF THE REDWOODS

Practice address

4750 Hoen Ave
Santa Rosa, CA 95405-7824

Phone

(707) 523-2666

Fax

(707) 523-3399

NPI assigned

Oct 12, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Marie Phillips

Title

Credentialing Specialist

Phone

(707) 473-4531

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1033208798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 HEALDSBURG AVE",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954489617",
            "telephone_number": "707-473-4500",
            "fax_number": "707-473-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057824",
            "telephone_number": "707-523-2666",
            "fax_number": "707-523-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "707-473-4531"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sutter Medical Center of Santa Rosa
• Sutter Medical Center of Santa Rosa Tcu
• Sutter Medical Foundation (Sutter Medical Foundation North Bay)
• Sutter Medical Foundation North Bay
• Sutter Medical Group of the Redwoods
• Sutter Medical Group of the Redwoods
• Sutter Medical Group of the Redwoods
• Sutter Medical Group of the Redwoods
• Sutter Medical Group of the Redwoods
• Sutter Medical Group of the Redwoods

• Family Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.