Individual provider Active NPI

Nora Von Sydow, FNP

  • Family Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1235538570
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014008837 Issued in CA
Practice address
34 Mark West Springs Rd FL 2
Santa Rosa, CA 95403
Phone
(707) 541-7900
Fax
(707) 573-5412
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014008837 CA Primary

Addresses

Primary practice location

34 Mark West Springs Rd FL 2
Santa Rosa, CA 95403

Mailing address

2350 W El Camino Real FL 2
Mountain View, CA 94040-6203
Phone (707) 541-7900

Other practice location 1

14045 Mill St
Guerneville, CA 95446-8303
Phone (707) 869-5977 ext. 3310

Other identifiers 3

IdentifierTypeStateIssuer
FNP95001184OtherCASTATE MEDICAL LICENSE
RN788678OtherCASTATE MEDICAL LICENSE
NP95001184OtherCASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141006001605 CA Order and Referring Only - Nurse Practitioner 8123248655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014008837CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: nvonsydow264347@hisp.ehr.sutterhealth.org

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1235538570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203",
            "telephone_number": "707-541-7900",
            "fax_number": "707-573-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MARK WEST SPRINGS RD FL 2",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-541-7900",
            "fax_number": "707-573-5412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14045 Mill St",
            "address_purpose": "LOCATION",
            "city": "Guerneville",
            "state": "CA",
            "postal_code": "954468303",
            "country_code": "US",
            "telephone_number": "707-869-5977 x3310",
            "fax_number": "707-869-5983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON SYDOW",
        "first_name": "NORA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "2014008837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "FNP95001184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "RN788678",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "NP95001184",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.