Organization Active NPI

Merced Pulmonary Medical Assoc.

  • Pulmonary Disease Physician
  • Merced, CA
National Provider Identifier
1114968765
Registry record updated Mar 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
GR0045160 Issued in CA
Legal business name
MERCED PULMONARY MEDICAL ASSOC.
Practice address
780 W Olive Ave.
Ste 103
Merced, CA 95348
Phone
(209) 526-8038
Fax
(209) 526-6841
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2008

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

Authorized official

Name
Nick Maddocks
Title
President
Phone
(209) 526-8038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X GR0045160 CA Primary

Addresses

Primary practice location

780 W Olive Ave.
Ste 103
Merced, CA 95348

Mailing address

780 W Olive Ave.
Ste 103
Merced, CA 95348
Phone (209) 723-0783

Other identifiers 1

IdentifierTypeStateIssuer
C41002OtherCAMEDICARE ID

National Provider Directory

National Provider Directory

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204761600000",
    "number": "1114968765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 W OLIVE AVE.",
            "address_2": "STE 103",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-723-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 W OLIVE AVE.",
            "address_2": "STE 103",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "95348",
            "telephone_number": "209-526-8038",
            "fax_number": "209-526-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCED PULMONARY MEDICAL ASSOC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-03-06",
        "status": "A",
        "authorized_official_last_name": "MADDOCKS",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-526-8038"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "GR0045160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "C41002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.