Table Mountain Rancheria Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G42148 Issued in CA

Legal business name

TABLE MOUNTAIN RANCHERIA MEDICAL CENTER

Practice address

23638 Sky Harbour Rd
Friant, CA 93626-0410

Phone

(559) 822-3785

Fax

(559) 822-2928

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Marilyn O Benck, MDNPI 1134297641

Title

Medical Director

Phone

(559) 822-3785

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

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

• Marilyn Olufs Benck, MD

  • Internal Medicine Physician
  • Friant, CA
  • NPI 1134297641

  Internal Medicine

  NPD (past) Authorized official
• William Charles Parent, P.A.

  • Medical Physician Assistant
  • Friant, CA
  • NPI 1669461745
  NPD (past)
• Lizette Rodriguez, MD, MS

  • Internal Medicine Physician
  • Sacramento, CA
  • NPI 1972150324

  Internal Medicine

  NPD (past)
• Jenee Nicole Kautzer, ARNP, FNP-C

  • Family Nurse Practitioner
  • Vancouver, WA
  • NPI 1386910750
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1093983389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410",
            "city": "FRIANT",
            "state": "CA",
            "postal_code": "936260410",
            "telephone_number": "559-822-3785",
            "fax_number": "559-822-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23638 SKY HARBOUR RD",
            "city": "FRIANT",
            "state": "CA",
            "postal_code": "936260410",
            "telephone_number": "559-822-3785",
            "fax_number": "559-822-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABLE MOUNTAIN RANCHERIA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "BENCK",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-822-3785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G42148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Charles Parent, P.A.
• Bryan Peter Peters, PHARM.D.
• Ronnie Elizabeth Potts, FNP
• Diane Lee Ramirez, O.D.
• Frederick Reschman Reschman Jr., R.N.

• All providers in Friant, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.