Shiree Fatch Medical Corporation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SHIREE FATCH MEDICAL CORPORATION

Practice address

1650 Lead Hill Blvd Ste 400
Roseville, CA 95661-3072

Phone

(916) 783-0580

NPI assigned

Apr 22, 2025

Organization subpart

No

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

Authorized official

Name

Shiree Segev Fatch, DONPI 1659833549

Title

Owner

Phone

(916) 783-0580

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Shiree Segev Fatch, DO

  • Pediatrics Physician
  • Roseville, CA
  • NPI 1659833549
  NPD Authorized official
• Nalini G Prasad, MD

  • Dermatology Physician
  • Roseville, CA
  • NPI 1972856490
  NPD (past)

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1063209237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD STE 400",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD STE 400",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613072",
            "telephone_number": "916-783-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIREE FATCH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "FATCH",
        "authorized_official_first_name": "SHIREE",
        "authorized_official_middle_name": "SEGEV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-783-0580",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ling Shi-Bertsch, MD
• Megan Dorothy Shidler
• Kyu Min Shim, MD
• Grace Shin
• Courtney Lee Shinn, RT
• Jill Elizabeth Shirley, M.A.
• Karen Leanne Shirley, SUDCC11
• Erin Elizabeth Shiue, PA-C
• Harn-Cherng Shiue, M.D.
• Igor Shkuratov

• Pediatrics Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.