NPIMap

Organization Active NPI

Kaiser Foundation Hospitals

Doing business as Kaiser FDN HSP Inp Discharge Phy 39a 394

  • Institutional Pharmacy
  • San Rafael, CA
National Provider Identifier
1205984002
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
HSP39139 Issued in CA
Legal business name
KAISER FOUNDATION HOSPITALS
Doing business as
Kaiser FDN HSP Inp Discharge Phy 39a 394
Practice address
99 Montecillo Rd
San Rafael, CA 94903-3308
Phone
(415) 444-2047
Fax
(415) 444-2077
NPI assigned
Jan 8, 2007
Last updated
Apr 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Kathryn Renouard Brown
Title
VP Pharmacy Operations and Services
Phone
(510) 625-2363

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU
Institutional Pharmacy 3336I0012X HSP39139 CA Primary

Addresses

Primary practice location

99 Montecillo Rd
San Rafael, CA 94903-3308

Mailing address

1800 Harrison St FL 13
Oakland, CA 94612-3466

Other identifiers 2

IdentifierTypeStateIssuer
0561919OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHB187490MedicaidCA

Other names 1

  • KAISER FDN HSP INP DISCHARGE PHY 39A 394 Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Daniel Gussin185 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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1205984002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 13",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MONTECILLO RD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033308",
            "telephone_number": "415-444-2047",
            "fax_number": "415-444-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "RENOUARD",
        "authorized_official_title_or_position": "VP PHARMACY OPERATIONS AND SERVICES",
        "authorized_official_telephone_number": "510-625-2363"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "CA",
            "license": "HSP39139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0561919",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHB187490",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "99 Montecillo Rd",
            "city": "San Rafael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "949033308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "KAISER FDN HSP INP DISCHARGE PHY 39A 394",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KAISER FDN HSP INP DISCHARGE PHY 39A 394",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.