Jack Linn Bellah, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G47828 Issued in CA

Practice address

721 River Dr
Suite B
Fort Bragg, CA 95437

Phone

(707) 964-6910

Fax

(707) 964-7430

NPI assigned

Oct 5, 2006

Last updated

Oct 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jones and Bellah MDS

  • Specialist
  • Fortuna, CA
  • NPI 1255458626
  NPD (past) Authorized official
• Theophil Jantz, D.O., Inc

  • Surgery Physician
  • Fort Bragg, CA
  • NPI 1902017932
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1235225376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34120",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895334120",
            "telephone_number": "775-747-5050",
            "fax_number": "775-747-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 RIVER DR",
            "address_2": "SUITE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-964-6910",
            "fax_number": "707-964-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAH",
        "first_name": "JACK",
        "middle_name": "LINN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G47828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine R. Barlow, PHARMD
• Willow Bartholomew, PA
• Kenneth Roger Baumgartner, DDS
• Carrie Becker Fishman
• Joseph Edward Beeney, PHD
• Logan Christopher Bengston, LMFT
• Zoe D Berna, MD
• Jeff Bertheola, DDS
• Mary Josephine Bever
• Janet Lynn Biasca, RPH

• Orthopaedic Surgery Physician in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.