NPIMap

Organization Active NPI

Sonora Community Hospital

Doing business as Sierra Family Practice

  • Family Medicine Physician
  • Sonora, CA
National Provider Identifier
1306837133
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SONORA COMMUNITY HOSPITAL
Doing business as
Sierra Family Practice
Practice address
12811 Covey Cir
Sonora, CA 95370-5935
Phone
(209) 588-8840
Fax
(209) 533-7696
NPI assigned
Nov 1, 2005
Last updated
Apr 23, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SONORA COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Authorized official

Name
Andrew D. Jahn
Title
Vice President for Finance
Phone
(209) 536-5011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

12811 Covey Cir
Sonora, CA 95370-5935

Mailing address

14542 Lolly LN
Sonora, CA 95370-9226
Phone (209) 536-2760

Other names 1

  • Sierra Family Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sonora Community7 organizations share this tax ID, including this one
Part of
Sonora Community

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1306837133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14542 LOLLY LN",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709226",
            "telephone_number": "209-536-2760",
            "fax_number": "209-533-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 COVEY CIR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705935",
            "telephone_number": "209-588-8840",
            "fax_number": "209-533-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORA COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SONORA COMMUNITY HOSPITAL",
        "enumeration_date": "2005-11-01",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "JAHN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE",
        "authorized_official_telephone_number": "209-536-5011"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sierra Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.