NPIMap

Organization Active NPI

John Muir Health

Doing business as John Muir Health - Walnut Creek Campus

  • Nurse Practitioner
  • Walnut Creek, CA
National Provider Identifier
1174890305
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
140000285 Issued in CA
Legal business name
JOHN MUIR HEALTH
Doing business as
John Muir Health - Walnut Creek Campus
Practice address
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122
Phone
(925) 939-3000
Fax
(925) 947-3255
NPI assigned
Nov 16, 2011
Last updated
Nov 16, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHN MUIR HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Authorized official

Name
Mr. Michael D. Moody
Title
Chief Financial Officer
Phone
(925) 941-2159

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X 140000285 CA Primary

Addresses

Primary practice location

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598-3122

Mailing address

1400 Treat Blvd
Walnut Creek, CA 94597-2142
Phone (925) 939-3000

Other names 1

  • John Muir Health - Walnut Creek Campus Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John Muir Med Ctr Path8 organizations share this tax ID, including this one
Part of
John Muir Med Ctr Path

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321401600000",
    "number": "1174890305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TREAT BLVD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972142",
            "telephone_number": "925-939-3000",
            "fax_number": "925-941-2236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 YGNACIO VALLEY RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983122",
            "telephone_number": "925-939-3000",
            "fax_number": "925-947-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MUIR HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN MUIR HEALTH",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "925-941-2159",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "140000285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John Muir Health - Walnut Creek Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.