Active NPI
William Henry Tellman, MD
- Internal Medicine Physician
- Meadow Vista, CA
National Provider Identifier
1164685376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- GFE14562
- Practice address
- 17248 Placer Hills Rd
Meadow Vista, CA 95722-1292 - Phone
- (530) 878-6293
- Fax
- (530) 878-6293
- NPI assigned
- Jul 8, 2008
- Last updated
- Jul 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | GFE14562 | CA | Primary |
Addresses
Primary practice location
17248 Placer Hills Rd
Meadow Vista, CA 95722-1292
Mailing address
17248 Placer Hills Rd /PO Box 1292
Meadow Vista, CA 95722-1292
Phone (530) 878-6293
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GFE14562 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1164685376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17248 PLACER HILLS RD /PO BOX 1292",
"city": "MEADOW VISTA",
"state": "CA",
"postal_code": "957221292",
"telephone_number": "530-878-6293",
"fax_number": "530-878-6293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17248 PLACER HILLS RD",
"city": "MEADOW VISTA",
"state": "CA",
"postal_code": "957221292",
"telephone_number": "530-878-6293",
"fax_number": "530-878-6293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLMAN",
"first_name": "WILLIAM",
"middle_name": "HENRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-08",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "GFE14562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meadow Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.