Individual provider Active NPI

Vincent D. Duncan, RADT

  • Case Manager/Care Coordinator
  • Huntington Beach, CA
National Provider Identifier
1043980428
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
R1379530320 Issued in CA
Practice address
17822 Beach Blvd Ste 278
Huntington Beach, CA 92647-7180
Phone
(714) 375-3795
Fax
(714) 375-3796
NPI assigned
Sep 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X R1379530320 CA Primary

Addresses

Primary practice location

17822 Beach Blvd Ste 278
Huntington Beach, CA 92647-7180

Mailing address

301 N Ford Ave Apt 219
Fullerton, CA 92832-1460
Phone (213) 999-7405

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL GenesisNB.org Genesis New Beginning

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1379530320CAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1043980428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N FORD AVE APT 219",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321460",
            "telephone_number": "213-999-7405",
            "fax_number": "657-378-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD STE 278",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477180",
            "telephone_number": "714-375-3795",
            "fax_number": "714-375-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "VINCENT",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "RADT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": "R1379530320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GenesisNB.org",
            "affiliation": "Y",
            "affiliationName": "Genesis New Beginning",
            "address_1": "17822 Beach Blvd",
            "city": "Hunt",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.