St Nazarene Medical Clinic Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A055383 Issued in CA

Legal business name

ST NAZARENE MEDICAL CLINIC INC

Practice address

1100 N Ventura Rd
Suite 109
Oxnard, CA 93030-3841

Phone

(805) 983-0547

Fax

(805) 983-0423

NPI assigned

Nov 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Suzanne L Fussell, MDNPI 1942394457

Title

President

Phone

(805) 983-0547

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

St Nazarines Medical CL2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• St Nazarene Medical Clinic Inc

  • Primary Care Clinic/Center
  • Long Beach, CA
  • NPI 1093966822
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• St Nazarene Medical Clinic Inc

  • Primary Care Clinic/Center
  • Long Beach, CA
  • NPI 1093966822
  NPPES parent name

Practitioners 2

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

• Suzanne L Fussell, MD

  • Family Medicine Physician
  • Oxnard, CA
  • NPI 1942394457
  Medicare reassignment NPD Authorized official
• Joseph Iwuajoku, PA

  • Physician Assistant
  • Long Beach, CA
  • NPI 1922397876
  NPD (past)

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1275714917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NORTH VENTURA RD",
            "address_2": "SUITE 109",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303814",
            "telephone_number": "805-983-0547",
            "fax_number": "805-983-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N VENTURA RD",
            "address_2": "SUITE 109",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303841",
            "telephone_number": "805-983-0547",
            "fax_number": "805-983-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST NAZARENE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "FUSSELL",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-983-0547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A055383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shenalle Letrice Squires
• John Joseph Sramek, PHARM.D.
• SSG Anesthesia Inc (Saralee Glaser, CRNA Anesthesia Services Inc.)
• St Johns Regional Imaging Center LLC
• St Johns Regional Imaging Center LLC
• St Thomas Aquinas Home
• St. John's Outpatient Surgery Center, LP (St. John's Outpatient Surgery Center)
• John Sta Maria
• Sharon R Staber, LMFT, APPC
• Stanley Frochtzwajg, M.D.

• Primary Care Clinic/Center in Oxnard, CA
• Providers in Oxnard, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.