Individual provider Active NPI

Jeffrey C Ricks, M.D.

  • Emergency Medicine Physician
  • Twentynine Palms, CA
National Provider Identifier
1063476752
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A85778 Issued in CA
Practice address
1145 Sturgis Road
Twentynine Palms, CA 92278-8275
Phone
(760) 830-2354
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01058306A IN
Emergency Medicine Physician 207P00000X A85778 CA Primary

Addresses

Primary practice location

1145 Sturgis Road
Twentynine Palms, CA 92278-8275

Mailing address

1145 Sturgis Road
Twentynine Palms, CA 92278-8275
Phone (760) 830-2354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140905001937 CA Practitioner - Emergency Medicine 1759509607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85778CAMDEmergency Medicine Physician
01058306AINMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Star Hospital Associates Inc. Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Seven Star Hospital Associates Inc. CurrentSince Aug 1, 2022 Accepting new patients

Locations

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1063476752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788275",
            "telephone_number": "760-830-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922788275",
            "telephone_number": "760-830-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKS",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2022-04-08",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01058306A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A85778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

Verify at the official NPI Registry.