Central California Chest Surgery

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

A99566 Issued in CA

Legal business name

CENTRAL CALIFORNIA CHEST SURGERY

Practice address

729 N Medical Center Dr W Ste 223
Clovis, CA 93611-6885

Phone

(559) 449-9990

Fax

(559) 449-9991

NPI assigned

Nov 1, 2016

Last updated

Feb 4, 2020By 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

Mrs. Gloria Supernaw

Title

Billing and Contracting Manager

Phone

(559) 935-5491

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Chih-Chieh Lin, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Fresno, CA
  • NPI 1992961270
  Medicare reassignment NPD
• Suzanne Vartanian, NP

  • Family Nurse Practitioner
  • Fresno, CA
  • NPI 1558922443
  Medicare reassignment NPD
• Christopher Jon Kampfe Jr., PA-C

  • Physician Assistant
  • Fresno, CA
  • NPI 1154333045
  Medicare reassignment

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580774400000",
    "number": "1073065512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 N MEDICAL CENTER DR W STE 223",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116885",
            "telephone_number": "559-449-9990",
            "fax_number": "559-449-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 N MEDICAL CENTER DR W STE 223",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116885",
            "telephone_number": "559-449-9990",
            "fax_number": "559-449-9991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7575 N Cedar Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202693",
            "country_code": "US",
            "telephone_number": "559-449-9990",
            "fax_number": "559-449-9991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA CHEST SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2020-02-04",
        "certification_date": "2020-02-04",
        "status": "A",
        "authorized_official_last_name": "SUPERNAW",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "BILLING AND CONTRACTING MANAGER",
        "authorized_official_telephone_number": "559-935-5491",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A99566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Dan Caton
• Joshua Caudillo
• Lesley Yvonne Celio-Ramirez
• Cencal Medical Transport LLC
• Central Cal Speech Inc
• Central California Faculty Medical Group, Inc.
• Central Valley Behavioral Health Psychology Corporation (Ascend Behavioral Health)
• Central Valley Behavioral Health Psychology Corporation (Ascend Behavioral Health)
• Central Valley Indian Health
• Central Valley Indian Health, Inc

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Clovis, CA
• Providers in Clovis, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.