NPIMap

Organization Active NPI

Recover Medical Group PC

  • Addiction Psychiatry Physician
  • Roseville, CA
National Provider Identifier
1306603089
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
Legal business name
RECOVER MEDICAL GROUP PC
Practice address
8150 Sierra College Blvd Ste 250
Roseville, CA 95661-9417
Phone
(858) 208-0121
NPI assigned
Feb 29, 2024
Organization subpart
Yes
Parent organization
RECOVER MEDICAL GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Ian Matthew Christensen-Gibbons
Title
Head of Operations
Phone
(310) 913-0781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X Primary

Addresses

Primary practice location

8150 Sierra College Blvd Ste 250
Roseville, CA 95661-9417

Mailing address

120 Birmingham Dr Ste 240a
Cardiff, CA 92007-1757
Phone (858) 208-0121

National Provider Directory

National Provider Directory
Tax ID family
Recover Medical Group PC8 organizations share this tax ID, including this one
Part of
Recover Medical Group PC

Other organizations with this tax ID 7

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1306603089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BIRMINGHAM DR STE 240A",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071757",
            "telephone_number": "858-208-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 SIERRA COLLEGE BLVD STE 250",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956619417",
            "telephone_number": "858-208-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVER MEDICAL GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RECOVER MEDICAL GROUP PC",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN-GIBBONS",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "HEAD OF OPERATIONS",
        "authorized_official_telephone_number": "310-913-0781"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.