NPIMap

Individual provider Active NPI

Reece Fenning, MD, MPH

  • Family Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1124604699
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A193019 Issued in CA
Practice address
30 Mark West Springs Rd
Santa Rosa, CA 95403-1436
Phone
(707) 576-4000
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A193019 CA Primary

Addresses

Primary practice location

30 Mark West Springs Rd
Santa Rosa, CA 95403-1436

Mailing address

601 Van Ness Ave Ste E3619
San Francisco, CA 94102-3200
Phone (415) 531-9047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025003287 CA Practitioner - Family Practice 1355874546 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Un of California, Irvine, College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonoma County Indian Health Project Inc 31 clinicians
Pacific Inpatient Medical Group 128 clinicians
West County Health Centers, Inc. 20 clinicians

Practice addresses (Care Compare)

144 Stony Point Rd
Santa Rosa, CA 95401-4122
Phone (707) 521-4545

3555 Cesar Chavez
San Francisco, CA 94110-4403
Phone (415) 485-8824

PO Box
Suite 1449
Guerneville, CA 95446

Hospital & facility affiliations

  • Sutter Santa Rosa Regional Hospital Hospital, Santa Rosa, CA, CCN 050291
  • Sutter Lakeside Hospital Hospital, Lakeport, CA, CCN 051329
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A193019CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Inpatient Medical Group CurrentSince Oct 29, 2024 Accepting new patients
Sonoma County Indian Health Project, Inc Family Medicine CurrentSince Jan 2, 2025 Accepting new patients
Sonoma County Indian Health Project, Inc Family Medicine Past Accepting new patients
Sonoma County Indian Health Project, Inc Past Accepting new patients
Sutter West Bay Medical Foundation Family Medicine PastSince Mar 1, 2021 Accepting new patients

Locations

601 Van Ness Ave
Ste E3619
San Francisco, CA 94102
Phone (415) 531-9047

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

144 Stony Point Rd
Santa Rosa, CA 95401
Phone (707) 521-4500

30 Mark West Springs Rd
Santa Rosa, CA 95403
Phone (707) 576-4000

Interoperability endpoints

  • Direct secure messaging: reece.fenning.p1@direct.scihp.nextgenshare.com
  • Direct secure messaging: rfenning581743@hisp.ehr.sutterhealth.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1124604699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 VAN NESS AVE STE E3619",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023200",
            "telephone_number": "415-531-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MARK WEST SPRINGS RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031436",
            "telephone_number": "707-576-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNING",
        "first_name": "REECE",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A193019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.