Organization Active NPI

Sutter Gould Medical Foundation

Doing business as Briggsmore Specialty Center

  • Internal Medicine Physician
  • Modesto, CA
National Provider Identifier
1255378873
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUTTER GOULD MEDICAL FOUNDATION
Doing business as
Briggsmore Specialty Center
Practice address
1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone
(209) 524-1211
NPI assigned
Jun 1, 2006
Last updated
Oct 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Steven A Mitnick, MD
Title
Medical Director
Phone
(209) 521-6097

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Gastroenterology Physician 207RG0100X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Surgery Physician 208600000X NU

Addresses

Primary practice location

1409 E Briggsmore Ave
Modesto, CA 95355-2707

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Other names 1

  • Briggsmore Specialty Center Doing business as

National Provider Directory

National Provider Directory

Locations

1409 E Briggsmore Ave
Modesto, CA 95355
Phone (209) 550-4725

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1255378873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-524-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRIGGSMORE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552707",
            "telephone_number": "209-524-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER GOULD MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "MITNICK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-521-6097",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Briggsmore Specialty Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.