Northern California Medical Assoc Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

NORTHERN CALIFORNIA MEDICAL ASSOC INC

Practice address

84 Madrone St
Willits, CA 95490-4249

Phone

(707) 459-6855

Fax

(707) 459-9585

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Ruth Ann Skidmore

Title

Chief Executive Officer

Phone

(707) 573-6925

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1174525554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-525-6485",
            "fax_number": "707-573-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MADRONE ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904249",
            "telephone_number": "707-459-6855",
            "fax_number": "707-459-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-573-6925",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0001732",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ45620Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Jean Murphy, D.C.
• Earl Tobias Myers, O.D.
• Rahel Negash, PHARMD
• Kyle Christopher Neuer, RN
• Gregory Allan Niderost
• Elias Wassie Nuru, RPH
• Mary Simisola Ogunmeru, PHARMD
• Natalia Ordonez
• Doreen May Orme, P.T.
• Carol Orton, L.C.S.W.

• Cardiovascular Disease Physician in Willits, CA
• Providers in Willits, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.