Organization Active NPI

Healthy Steps Weight Loss Center Medical Corporation

  • Surgery Physician
  • Santa Rosa, CA
National Provider Identifier
1225103369
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HEALTHY STEPS WEIGHT LOSS CENTER MEDICAL CORPORATION
Practice address
4730 Hoen Avenue
Santa Rosa, CA 95405
Phone
(707) 577-7800
Fax
(707) 525-0538
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Robert O Woodbury, M.D.NPI 1871607937
Title
President
Phone
(707) 577-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

4730 Hoen Avenue
Santa Rosa, CA 95405

Mailing address

4730 Hoen Avenue
Santa Rosa, CA 95405
Phone (707) 577-7800

Other identifiers 1

IdentifierTypeStateIssuer
GR0102070MedicaidCA

Other names 1

  • Healthy Steps Weight Loss Center Other name

National Provider Directory

National Provider Directory

Locations

4730 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 528-1616

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1225103369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 HOEN AVENUE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-577-7800",
            "fax_number": "707-525-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 HOEN AVENUE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-577-7800",
            "fax_number": "707-525-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY STEPS WEIGHT LOSS CENTER MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "WOODBURY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-577-7800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Steps Weight Loss Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.