Stanislaus Health and Wellness Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

STANISLAUS HEALTH AND WELLNESS INC

Doing business as

209 Urgent Care

Practice address

1908 Coffee Rd Ste 3
Modesto, CA 95355

Phone

(209) 846-9429

Fax

(209) 551-1665

NPI assigned

Nov 7, 2017

Last updated

Sep 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George I JacobNPI 1770584112

Title

President

Phone

(209) 846-9429

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• 209 Urgent Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Baltej Singh Dosanjh, M.D.

  • Family Medicine Physician
  • Modesto, CA
  • NPI 1346536711
  Medicare reassignment NPD
• George I Jacob, D.C.

  • Chiropractor
  • Modesto, CA
  • NPI 1770584112
  Authorized official Same address or phone

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1215440631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 578700",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953578700",
            "telephone_number": "209-551-0420",
            "fax_number": "209-551-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 COFFEE RD STE 3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-846-9429",
            "fax_number": "209-551-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAUS HEALTH AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-846-9429",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1447338355",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225073307",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "209 Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stanislaus County BHRS
• Stanislaus County Office of Education
• Stanislaus County Office of Education
• Stanislaus County, Dept of Aging and Veterans Services, MSSP
• Stanislaus Family Medicine Residency
• Stanislaus Optometric Center, Inc.
• Stanislaus Orthopaedic and Sports Medicine Clinic
• Stanislaus Orthopaedics Sports Medicine Clinic
• Stanislaus Subacute Rehab LLC
• Stanislaus Surgical Hospital LLC

• Urgent Care Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.