Organization Active NPI

Skypark Walk-in Medical Center

  • Internal Medicine Physician
  • Chico, CA
National Provider Identifier
1265634018
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G047884 Issued in CA
Legal business name
SKYPARK WALK-IN MEDICAL CENTER
Practice address
2485 Notre Dame Blvd
Ste 230
Chico, CA 95928-7161
Phone
(530) 899-9500
Fax
(530) 899-4040
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
John P Matheson
Title
Office Manager
Phone
(530) 899-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G047884 CA Primary

Addresses

Primary practice location

2485 Notre Dame Blvd
Ste 230
Chico, CA 95928-7161

Mailing address

2485 Notre Dame Blvd
Ste 230
Chico, CA 95928-7161
Phone (530) 899-9500

Other identifiers 1

IdentifierTypeStateIssuer
G47884OtherCAMEDICAL LICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

2485 Notre Dame Blvd
Ste 230
Chico, CA 95928
Phone (530) 899-9500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1265634018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 NOTRE DAME BLVD",
            "address_2": "STE 230",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287161",
            "telephone_number": "530-899-9500",
            "fax_number": "530-899-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 NOTRE DAME BLVD",
            "address_2": "STE 230",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959287161",
            "telephone_number": "530-899-9500",
            "fax_number": "530-899-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYPARK WALK-IN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MATHESON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "530-899-9500"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G047884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "G47884",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.