NPIMap

Organization Active NPI

Salud

Doing business as St Joan of Arc Medical Center

  • Family Medicine Physician
  • Blythe, CA
National Provider Identifier
1326123399
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G11503 Issued in CA
Legal business name
SALUD
Doing business as
St Joan of Arc Medical Center
Practice address
176 S Palm Drive
Blythe, CA 92225
Phone
(760) 922-1020
Fax
(760) 922-1050
NPI assigned
Oct 26, 2006
Last updated
Jan 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Dr. David Brooks, MDNPI 1568642221
Title
Ceo
Phone
(960) 922-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G11503 CA Primary

Addresses

Primary practice location

176 S Palm Drive
Blythe, CA 92225

Mailing address

176 S Palm Drive
Blythe, CA 92225
Phone (760) 922-1020

Other identifiers 1

IdentifierTypeStateIssuer
00G115032MedicaidCA

Other names 1

  • St Joan of Arc Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1326123399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 S PALM DRIVE",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "92225",
            "telephone_number": "760-922-1020",
            "fax_number": "760-922-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 S PALM DRIVE",
            "city": "BLYTHE",
            "state": "CA",
            "postal_code": "92225",
            "telephone_number": "760-922-1020",
            "fax_number": "760-922-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "960-922-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G11503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G115032",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Joan of Arc Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blythe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.