Organization Active NPI

Placer Private Physicians Inc

  • Family Medicine Physician
  • Rocklin, CA
National Provider Identifier
1164830360
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLACER PRIVATE PHYSICIANS INC
Practice address
6960 Destiny Dr
Suite 100
Rocklin, CA 95677-2993
Phone
(916) 624-1777
Fax
(916) 624-1770
NPI assigned
Jul 31, 2014
Last updated
Jul 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Authorized official

Name
Bron Christopher Hedman, MDNPI 1093793242
Title
Owner
Phone
(916) 624-1777

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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6960 Destiny Dr
Suite 100
Rocklin, CA 95677-2993

Mailing address

6960 Destiny Dr
Suite 100
Rocklin, CA 95677-2995
Phone (916) 624-1777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141114001251 CA Part B Supplier - Clinic/Group Practice 3476775040 Receives reassigned benefits from 4 practitioners
Practice locations: Rocklin, 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
05D2087007Placer Private Physicians6960 Destiny Dr Ste 100, Rocklin, CA 95677Provider-performed microscopyNov 13, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1164830360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6960 DESTINY DR",
            "address_2": "SUITE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772995",
            "telephone_number": "916-624-1777",
            "fax_number": "916-624-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6960 DESTINY DR",
            "address_2": "SUITE 100",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956772993",
            "telephone_number": "916-624-1777",
            "fax_number": "916-624-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACER PRIVATE PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "HEDMAN",
        "authorized_official_first_name": "BRON",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-624-1777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.