Adventist Health Physicians Network

Key facts

NPI

1033416136

Entity type

Organization (NPI type 2)

Primary specialty

Orthopaedic Surgery Physician 207X00000X

Legal business name

ADVENTIST HEALTH PHYSICIANS NETWORK

Practice address

18990 Coyote Valley Rd
Ste. 5
Hidden Valley Lake, CA 95467-8337

Phone

(707) 967-5721

NPI assigned

Feb 25, 2011

Organization subpart

Yes

Parent organization (as reported)

ADVENTIST HEALTHPHYSICIANS NETWORK

Authorized official

Name

Mr. Jeffrey M. Conklin

Title

President

Phone

(916) 789-4209

Practitioners 2

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

• Autumn Burnes, M.D. Family Medicine Physician · Santa Rosa, CA · NPI 1134650286
  NPD
• Ashley Nitasha Bedi, DO Physical Medicine & Rehabilitation Physician · Lodi, CA · NPI 1770076994
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Medicare enrollment records

National Provider Directory

Part of

Clafiornia Med FD

Locations

Specialties & licenses

Addresses

Other names

• Coon Joint Replacement Institute Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 13, 2011.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1033416136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD",
            "address_2": "STE.5",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678337",
            "telephone_number": "707-968-2809",
            "fax_number": "707-963-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18990 COYOTE VALLEY RD",
            "address_2": "STE. 5",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678337",
            "telephone_number": "707-967-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTHPHYSICIANS NETWORK",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-789-4209",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coon Joint Replacement Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hidden Valley Lake, CA

• Adventist Health California Medical Group, Inc.
• Adventist Health California Medical Group, Inc.
• Adventist Health California Medical Group, Inc.
• Adventist Health California Medical Group, Inc.
• Adventist Health Clearlake Hospital Inc
• Adventist Health Physicians Network
• Adventist Health Physicians Network
• Adventist Health Physicians Network
• Adventist Health Physicians Network
• Adventist Health Physicians Network

All providers in Hidden Valley Lake, CA · Orthopaedic Surgery Physician in California