Individual provider Active NPI

Dody Ufford, PA

  • Physician Assistant
  • Crescent City, CA
National Provider Identifier
1245304815
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14677 Issued in CA
Practice address
550 E Washington Blvd
Crescent City, CA 95531-8160
Phone
(707) 465-6925
Fax
(707) 465-6070
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA14677 CA
Physician Assistant 363A00000X PA14677 CA Primary

Addresses

Primary practice location

550 E Washington Blvd
Crescent City, CA 95531-8160

Mailing address

670 9TH St
Arcata, CA 95521-6248
Phone (707) 826-8633

Other practice location 1

1225 Marshall St
Suite 24
Crescent City, CA 95531-2281
Phone (707) 465-0884

Other practice location 2

1225 Marshall St
Suite 24
Crescent City, CA 95531-2281
Phone (707) 465-0884

Other identifiers 1

IdentifierTypeStateIssuer
PA14677MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14677CAMDOccupational Therapist
PA14677CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent City Internal Medicine PastSince Sep 1, 2006 Accepting new patients
Sutter West Bay Medical Foundation Past Accepting new patients
Sutter Bay Medical Foundation Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CABIAD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1245304815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318160",
            "telephone_number": "707-465-6925",
            "fax_number": "707-465-6070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Marshall St",
            "address_2": "SUITE 24",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955312281",
            "country_code": "US",
            "telephone_number": "707-465-0884",
            "fax_number": "707-465-8356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 Marshall St",
            "address_2": "SUITE 24",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955312281",
            "country_code": "US",
            "telephone_number": "707-465-0884",
            "fax_number": "707-465-8356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UFFORD",
        "first_name": "DODY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA14677",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA14677",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.