NPIMap

Individual provider Active NPI

William Jornlin, MD

  • Family Medicine Physician
  • Roseville, CA
National Provider Identifier
1235112160
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A064104 Issued in CA
Practice address
2261 Douglas Blvd
Roseville, CA 95661-3831
Phone
(916) 783-7109
Fax
(916) 783-3070
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A064104 CA Primary

Addresses

Primary practice location

2261 Douglas Blvd
Roseville, CA 95661-3831

Mailing address

2261 Douglas Blvd
Roseville, CA 95661-3831
Phone (916) 783-7109

Other identifiers 1

IdentifierTypeStateIssuer
00A641040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000524 CA Practitioner - Family Practice 3779644638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2800

Hospital & facility affiliations

  • Sutter Care at Home Home health agency, Roseville, CA, CCN 057545
  • Agapecare Home Health, Inc Home health agency, Rocklin, CA, CCN 053160
  • Sutter Auburn Faith Vna & Hospice Home health agency, Auburn, CA, CCN 557292
  • Northstar Healthcare Services Home health agency, Sacramento, CA, CCN 757243
  • Progressive Home Care - Auburn Home health agency, Auburn, CA, CCN 557482
  • Sutter Auburn Faith Hospital Hospital, Auburn, CA, CCN 050498
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
  • Sierra Nevada Memorial Hospital Hospital, Grass Valley, CA, CCN 050150
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A064104CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Chapa-de Indian Health Program Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.jornlin@cdih.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1235112160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2261 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613831",
            "telephone_number": "916-783-7109",
            "fax_number": "916-783-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2261 DOUGLAS BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613831",
            "telephone_number": "916-783-7109",
            "fax_number": "916-783-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORNLIN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A064104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A641040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.