NPIMap

Organization Active NPI

Sutter Valley Medical Foundation

Doing business as Sutter Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Davis, CA
National Provider Identifier
1174858435
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUTTER VALLEY MEDICAL FOUNDATION
Doing business as
Sutter Medical Foundation
Practice address
1340 Lake Blvd
Davis, CA 95616-5673
Phone
(530) 753-5338
NPI assigned
Oct 5, 2009
Last updated
Mar 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SUTTER VALLEY MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Kristin Keller
Title
Sr. Director, Planning and Alignmen
Phone
(650) 934-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1340 Lake Blvd
Davis, CA 95616-5673

Mailing address

PO Box 255228
Sacramento, CA 95865-5228
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
GPT001681MedicaidCA

Other names 1

  • Sutter Medical Foundation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120622000491 CA DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 9830094515 Practice locations: Davis, CA

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Sutter Valley Med Fndtn36 organizations share this tax ID, including this one
Part of
Sutter Valley Med Fndtn

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1174858435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 LAKE BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165673",
            "telephone_number": "530-753-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER VALLEY MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUTTER VALLEY MEDICAL FOUNDATION",
        "enumeration_date": "2009-10-05",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "SR. DIRECTOR, PLANNING AND ALIGNMEN",
        "authorized_official_telephone_number": "650-934-7000"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPT001681",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Medical Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.

Verify at the official NPI Registry.