NPIMap

Organization Active NPI

Ventura Urgent Care Center Medical Corp

Doing business as Ventura Ugent Care Center

  • Urgent Care Clinic/Center
  • Ventura, CA
National Provider Identifier
1164449971
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
VENTURA URGENT CARE CENTER MEDICAL CORP
Doing business as
Ventura Ugent Care Center
Practice address
5725 Ralston St Ste 101
Ventura, CA 93003-6053
Phone
(805) 658-2273
Fax
(805) 639-9446
NPI assigned
Jul 16, 2006
Last updated
Dec 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Mr. Richard Wagner IV, MDNPI 1316988561
Title
Administator
Phone
(805) 658-2273

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
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

5725 Ralston St Ste 101
Ventura, CA 93003-6053

Mailing address

5725 Ralston St Ste 101
Ventura, CA 93003-6053
Phone (805) 658-2273

Other identifiers 1

IdentifierTypeStateIssuer
W14141OtherCAPTAN

Other names 1

  • Ventura Ugent Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050129000255 CA Part B Supplier - Clinic/Group Practice 2365492089 Receives reassigned benefits from 16 practitioners
Practice locations: Ventura, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0930907Ventura Urgent Care Center5725 Ralston Street #101 Attention Hilda, Ventura, CA 93003Provider-performed microscopyJul 17, 2027

National Provider Directory

National Provider Directory

Locations

5725 Ralston St
Ste 101
Ventura, CA 93003
Phone (805) 658-2273

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1164449971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5725 RALSTON ST STE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036053",
            "telephone_number": "805-658-2273",
            "fax_number": "805-639-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5725 RALSTON ST STE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930036053",
            "telephone_number": "805-658-2273",
            "fax_number": "805-639-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTURA URGENT CARE CENTER MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "ADMINISTATOR",
        "authorized_official_telephone_number": "805-658-2273",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W14141",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ventura Ugent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.