Jennifer Michelle Guth, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP19107 Issued in CA

Practice address

260 Hospital Dr Ste 204
Ukiah, CA 95482

Phone

(707) 463-8032

Fax

(707) 468-9179

NPI assigned

Jun 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1184944530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2739",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822739",
            "telephone_number": "707-463-8000",
            "fax_number": "707-462-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 204",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-463-8032",
            "fax_number": "707-468-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTH",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP19107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NP19107",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny Marie Grissom
• Aura Gross, OPTICIAN
• Ellen M Grossman, CNM, RN
• Noemi Guerrero
• Kevin Louis Gutfeld, L.C.S.W.
• Ronald E Guth, M.D.
• Elizabeth (Libby) Ann Guthrie, ED.D.,M.A.
• Crystal Gutierrez
• Michael Gutierrez
• Brenda Guzman

• Nurse Practitioner in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.