Northern California Medical Assoc Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

NORTHERN CALIFORNIA MEDICAL ASSOC INC

Practice address

5196 Hill Rd E
Ste 202
Lakeport, CA 95453-6362

Phone

(707) 263-1777

Fax

(707) 263-8137

NPI assigned

Jul 15, 2005

Last updated

Feb 9, 2012By 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

Ms. Ruth Ann Skidmore

Title

Chief Executive Officer

Phone

(707) 573-6925

Specialties & licenses 3

Addresses

Other identifiers 2

Locations

Practitioners 13

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.

• Nicholas John Charlton, DC

  • Chiropractor
  • Santa Rosa, CA
  • NPI 1801753975
  NPD (past)
• Sarah Dudenhoeffer, D.O.

  • Diabetology (Family Medicine) Physician
  • Healdsburg, CA
  • NPI 1952835423
  NPD (past)
• Cheryl Jo Jones-Murray, N.P.

  • Family Nurse Practitioner
  • Lakeport, CA
  • NPI 1659372845
  NPD (past)
• Keith Forrest Korver, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Santa Rosa, CA
  • NPI 1316946130
  NPD (past)
• Clinton Lane VI, M.D.

  • Internal Medicine Physician
  • Sonoma, CA
  • NPI 1679564611
  NPD (past)
• Gary Lynn Maes, M.D.

  • Family Medicine Physician
  • Lakeport, CA
  • NPI 1134127939
  NPD (past)
• Christine Martinez, P.A.-C

  • Surgical Physician Assistant
  • Walnut Creek, CA
  • NPI 1871650523
  NPD (past)
• Michael James McDermott, M.D.

  • Orthopaedic Surgery Physician
  • Santa Rosa, CA
  • NPI 1750365102
  NPD (past)
• Tony Chien Nguyen, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Santa Rosa, CA
  • NPI 1922136647
  NPD (past)
• Jason Edward Pope, MD

  • Pain Medicine (Anesthesiology) Physician
  • Santa Rosa, CA
  • NPI 1215078647
  NPD (past)
• Steven Allen Smith, M.D.

  • Orthopaedic Surgery Physician
  • Santa Rosa, CA
  • NPI 1265416077
  NPD (past)
• Brian Thalhamer, D.C.

  • Chiropractor
  • Santa Rosa, CA
  • NPI 1528105335
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1235138926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-525-6485",
            "fax_number": "707-573-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5196 HILL RD E",
            "address_2": "STE 202",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536362",
            "telephone_number": "707-263-1777",
            "fax_number": "707-263-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-573-6925",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR000173C",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ29385Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nielson
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• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Northlake Internal Medicine
• Linda R Norton
• Barbara Nuckols, MA

• Cardiovascular Disease Physician in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.