Active NPI
Bi-Valley Medical Clinic, Inc.
- Methadone Clinic
- Sacramento, CA
National Provider Identifier
1174544092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- License
- 34-04
- Legal business name
- BI-VALLEY MEDICAL CLINIC, INC.
- Practice address
- 310 Harris Ave
Suite a, E, F, G
Sacramento, CA 95838-3249 - Phone
- (916) 649-6793
- Fax
- (916) 418-0174
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | 34-04 | CA | Primary |
Addresses
Primary practice location
310 Harris Ave
Suite a, E, F, G
Sacramento, CA 95838-3249
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (694) 704-8784
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0004552 | Medicaid | CA | |
| HDC70032F | Other | CA | MEDI-CAL |
Other names 1
- BAART Programs Norwood
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200508000000 | CA | Part B Supplier - Opioid Treatment Program (Otp) | 1557450426 |
1 other NPI on this enrollment Practice locations: Sacramento, CA; Carmichael, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2027724 | Bi-Valley Medical Clinic, Inc | Certificate of waiver | Jul 28, 2027 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Menlo Park, CA
- NPI 1184992331
Member Of
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722211200000",
"number": "1174544092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 LAKEPOINTE DR STE 117",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750576425",
"telephone_number": "694-704-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 HARRIS AVE",
"address_2": "SUITE A, E, F, G",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958383249",
"telephone_number": "916-649-6793",
"fax_number": "916-418-0174"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BI-VALLEY MEDICAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-23",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A",
"authorized_official_last_name": "JARVIE",
"authorized_official_first_name": "BRUCE",
"authorized_official_title_or_position": "VP, TREASURER",
"authorized_official_telephone_number": "214-379-3300"
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": "CA",
"license": "34-04",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0004552",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "HDC70032F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BAART Programs Norwood",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.