North Jetty Hospitalists Inc a Medical Corporation

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

202545078 Issued in CA

Legal business name

NORTH JETTY HOSPITALISTS INC A MEDICAL CORPORATION

Practice address

3800 Janes Road
Arcata, CA 95521-4742

Phone

(707) 822-3621

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Stefan E Schunk, MDNPI 1063473171

Title

President

Phone

(707) 822-3621

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Stefan Ernest Schunk, MD

  • Internal Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1063473171
  NPD (past) Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1306887765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60039",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910666039",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES ROAD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-822-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JETTY HOSPITALISTS INC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "SCHUNK",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-822-3621",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "202545078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0100520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Bay Radiology Medical Group, Inc.
• North Coast ENT Associates Inc
• North Coast Orthopaedics
• North Coast Orthopaedics & Sports Medicine
• North Coast Podiatry
• North Pacific Cardiology Medical
• North Pacific Cardiology Medical Group
• Northcoast Anesthesia Providers Inc
• Northcoast Internal Medicine, a Medical Corporation
• Cindy J Norvell, M.D.

• Emergency Medicine Physician in Arcata, CA
• Providers in Arcata, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.