Organization Active NPI

Linda Gerrits M D Inc a Professional Corp

  • Nephrology Physician
  • Westlake Village, CA
National Provider Identifier
1124353057
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G55503 Issued in CA
Legal business name
LINDA GERRITS M D INC A PROFESSIONAL CORP
Practice address
1220 La Venta Dr
Suite 207
Westlake Village, CA 91361-3703
Phone
(805) 494-7710
Fax
(805) 494-7793
NPI assigned
Oct 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Dr. Linda M Gerrits, M.D.NPI 1598875072
Title
Physician
Phone
(805) 494-7710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X G55503 CA Primary

Addresses

Primary practice location

1220 La Venta Dr
Suite 207
Westlake Village, CA 91361-3703

Mailing address

1220 La Venta Dr
Suite 207
Westlake Village, CA 91361-3703
Phone (805) 494-7710

Other identifiers 1

IdentifierTypeStateIssuer
00G555030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091028000546 CA Part B Supplier - Clinic/Group Practice 1557408283 Receives reassigned benefits from 1 practitioner
Practice locations: Westlake Village, CA

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": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1124353057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE 207",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-494-7710",
            "fax_number": "805-494-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 LA VENTA DR",
            "address_2": "SUITE 207",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913613703",
            "telephone_number": "805-494-7710",
            "fax_number": "805-494-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA GERRITS M D INC A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "GERRITS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "805-494-7710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G55503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G555030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.