Active NPI
Dody Ufford, PA
- Physician Assistant
- Crescent City, CA
National Provider Identifier
1245304815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14677
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA14677 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14677 | CA | MD | Occupational Therapist |
| PA14677 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crescent City Internal Medicine | Past | Accepting new patients | |
| Sutter West Bay Medical Foundation | Past | Accepting new patients | |
| Sutter Bay Medical Foundation | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Internal Medicine Physician
- Crescent City, CA
- NPI 1669468930
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Ambulatory Surgical Clinic/Center
- Santa Rosa, CA
- NPI 1811242563
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.