Individual provider Active NPI

Gegham Atanesyan

  • Non-emergency Medical Transport (VAN)
  • Fresno, CA
National Provider Identifier
1306249719
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
8V90774 Issued in CA
Practice address
2938 E Niles Ave
Fresno, CA 93720-4960
Phone
(559) 348-7989
Fax
(559) 297-4104
NPI assigned
Sep 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 8V90774 CA Primary

Addresses

Primary practice location

2938 E Niles Ave
Fresno, CA 93720-4960

Mailing address

2938 E Niles Ave
Fresno, CA 93720-4960
Phone (559) 348-7989

Other identifiers 1

IdentifierTypeStateIssuer
A9850966OtherCAWORKERS COMPENSATION

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
8V90774CAMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1306249719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2938 E NILES AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204960",
            "telephone_number": "559-348-7989",
            "fax_number": "559-297-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2938 E NILES AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204960",
            "telephone_number": "559-348-7989",
            "fax_number": "559-297-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATANESYAN",
        "first_name": "GEGHAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "8V90774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "A9850966",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.