NPIMap

Organization Active NPI

Providence Medical Group

  • General Acute Care Hospital
  • Bakersfield, CA
National Provider Identifier
1194196832
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
PA19685 Issued in CA
Legal business name
PROVIDENCE MEDICAL GROUP
Practice address
1806 Wadsworth Avenue
Bakersfield, CA 93311
Phone
(805) 748-1687
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Mr. Matthew Tate, PA-C
Title
Physician Assistant
Phone
(805) 748-1687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PA19685 CA Primary

Addresses

Primary practice location

1806 Wadsworth Avenue
Bakersfield, CA 93311

Mailing address

1806 Wadsworth Avenue
Bakersfield, CA 93311
Phone (805) 748-1687

National Provider Directory

National Provider Directory
Tax ID family
Az Trans456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1194196832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 WADSWORTH AVENUE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93311",
            "telephone_number": "805-748-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 WADSWORTH AVENUE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93311",
            "telephone_number": "805-748-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "805-748-1687",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "PA19685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.