Active NPI
Adventist Health Physicians Network
- Orthopaedic Surgery Physician
- San Francisco, CA
National Provider Identifier
1174820344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- ADVENTIST HEALTH PHYSICIANS NETWORK
- Practice address
- 3727 Buchanan St
Suite. 310
San Francisco, CA 94123-5410 - Phone
- (707) 968-0670
- Fax
- (707) 968-9580
- NPI assigned
- Feb 23, 2011
- Organization subpart
- Yes
- Parent organization
- ADVENTIST HEALTH PHYSICIANS NETWORK
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jeffrey M. Conklin
- Title
- President
- Phone
- (916) 789-4209
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary | ||
| Medical Specialty Clinic/Center | 261QM2500X |
Addresses
Primary practice location
3727 Buchanan St
Suite. 310
San Francisco, CA 94123-5410
Mailing address
3727 Buchanan St
Suite. 310
San Francisco, CA 94123-5410
Phone (707) 968-0670
Other names 1
- Coon Joint Replacement Institute
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050407000633 | CA | Part B Supplier - Clinic/Group Practice | 3274580972 |
Receives reassigned benefits from 808 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Clafiornia Med FD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298419200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1302652800000",
"number": "1174820344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3727 BUCHANAN ST",
"address_2": "SUITE. 310",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941235410",
"telephone_number": "707-968-0670",
"fax_number": "707-968-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3727 BUCHANAN ST",
"address_2": "SUITE. 310",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941235410",
"telephone_number": "707-968-0670",
"fax_number": "707-968-9580"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ADVENTIST HEALTH PHYSICIANS NETWORK",
"enumeration_date": "2011-02-23",
"last_updated": "2011-04-13",
"status": "A",
"authorized_official_last_name": "CONKLIN",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "916-789-4209",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Coon Joint Replacement Institute",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.