NPIMap

Organization Active NPI

Elk Grove Urgent Care Inc

  • Urgent Care Clinic/Center
  • Elk Grove, CA
National Provider Identifier
1285812024
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
FNP36523 Issued in CA
Legal business name
ELK GROVE URGENT CARE INC
Practice address
9045 Bruceville Rd
Suite 100
Elk Grove, CA 95758-5948
Phone
(916) 479-9110
NPI assigned
Feb 4, 2008
Last updated
Sep 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Authorized official

Name
Allen I Lin, DONPI 1841271814
Title
Medical Director
Phone
(916) 479-9110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X FNP36523 CA Primary

Addresses

Primary practice location

9045 Bruceville Rd
Suite 100
Elk Grove, CA 95758-5948

Mailing address

9045 Bruceville Rd
Suite 100
Elk Grove, CA 95758-5948
Phone (916) 479-9110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080529000487 CA Part B Supplier - Clinic/Group Practice 0648340976 Receives reassigned benefits from 42 practitioners
Practice locations: Elk Grove, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1082182Elk Grove Urgent Care, Inc9045 Bruceville Rd, Ste 100, Elk Grove, CA 95758Provider-performed microscopyApr 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Elk Grove Urgent Care2 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.

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1285812024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "address_2": "SUITE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-479-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "address_2": "SUITE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-479-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE URGENT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-479-9110",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "FNP36523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.