Genesis Concierge Medicine

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

GENESIS CONCIERGE MEDICINE

Practice address

1230 Rosecrans Ave Ste 300
Manhattan Beach, CA 90266-2494

Phone

(562) 661-9104

Fax

(562) 286-8240

NPI assigned

Sep 26, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Brittani Hicks, DNP

Title

Ceo

Phone

(562) 661-9104

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1235852138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 ROSECRANS AVE STE 300",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662494",
            "telephone_number": "562-661-9104",
            "fax_number": "562-286-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 ROSECRANS AVE STE 300",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662494",
            "telephone_number": "562-661-9104",
            "fax_number": "562-286-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CONCIERGE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-25",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "BRITTANI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-661-9104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garfield Beach CVS LLC
• Gary M Lazarus OD PHD Apc
• John Gaspari, LCSW
• Heidi L Gastler, DPT
• Michelle Geelhoed, PHYSICIAN ASSISTANT
• Genesis Family Care Medical Group, Inc.
• Jason K Gentile, M.D.
• Aaron P Gerson, D.D.S.
• Tina Ghiassi, NP
• Sara Gilbert, MA LMFT

• Family Nurse Practitioner in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.