Individual provider Active NPI

Marcus Lynn Briggs

  • Health Maintenance Organization
  • Riverside, CA
National Provider Identifier
1285018036
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
45400 Issued in CA
Practice address
16851 Eagle Peak Rd
Riverside, CA 92504-8808
Phone
(951) 789-2914
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 45400 CA Primary

Addresses

Primary practice location

16851 Eagle Peak Rd
Riverside, CA 92504-8808

Mailing address

16851 Eagle Peak Rd
Riverside, CA 92504-8808
Phone (951) 789-2914

Other identifiers 1

IdentifierTypeStateIssuer
MEDICAIDMedicaidCA

Other names 1

  • Marcus Lynn Briggs Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
45400CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1285018036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16851 EAGLE PEAK RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925048808",
            "telephone_number": "951-789-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16851 EAGLE PEAK RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925048808",
            "telephone_number": "951-789-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGGS",
        "first_name": "MARCUS",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "45400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MEDICAID",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCUS",
            "last_name": "BRIGGS",
            "middle_name": "LYNN",
            "credential": "PHARM.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.