Organization Active NPI

Bhavani Inc

  • Family Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1093781189
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A54017 Issued in CA
Legal business name
BHAVANI INC
Practice address
1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700
Phone
(805) 542-0900
Fax
(805) 543-9580
NPI assigned
Feb 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Donella Jenkins, M.D.
Title
Ceo/Cfo
Phone
(805) 542-0900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A54017 CA Primary

Addresses

Primary practice location

1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700

Mailing address

1035 Peach Street
Suite 301
San Luis Obispo, CA 93401-2700
Phone (805) 542-0900

Other names 1

  • Healthworks of the Central Coast Doing business as

National Provider Directory

National Provider Directory

Locations

760 Morro Ave
Morro Bay, CA 93442

855 4th St
Ste 1
Pismo Beach, CA 93449
Phone (805) 773-4500

896 E Foothill Blvd
Ste B
San Luis Obispo, CA 93405
Phone (805) 542-0900

1035 Peach St
Ste 30
San Luis Obispo, CA 93401
Phone (805) 542-0900

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1093781189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PEACH STREET",
            "address_2": "SUITE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-542-0900",
            "fax_number": "805-543-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PEACH STREET",
            "address_2": "SUITE 301",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-542-0900",
            "fax_number": "805-543-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHAVANI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "DONELLA",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "805-542-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A54017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthworks of the Central Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.