C O R E Medical Clinic Inc

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

C O R E MEDICAL CLINIC INC

Practice address

2100 Capitol Ave
Sacramento, CA 95816-5721

Phone

(916) 442-4985

Fax

(916) 442-1029

NPI assigned

Dec 12, 2008

Last updated

Dec 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marshall Stenson

Title

Business Services Director

Phone

(916) 442-4985

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Opioid treatment program

Medicare-enrolled since Nov 21, 2023

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• C O R E Medical Clinic Inc

  • Methadone Clinic
  • West Sacramento, CA
  • NPI 1750865804

  O20100120000190, O20200213003019

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Core Medical Clinic Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• C O R E Medical Clinic Inc

  • Methadone Clinic
  • West Sacramento, CA
  • NPI 1750865804
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• C O R E Medical Clinic Inc

  • Methadone Clinic
  • West Sacramento, CA
  • NPI 1750865804
  NPPES parent name

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.

• Randall L Stenson, MD

  • Addiction Psychiatry Physician
  • Sacramento, CA
  • NPI 1164465357
  Medicare reassignment

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1326283706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CAPITOL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165721",
            "telephone_number": "916-442-4985",
            "fax_number": "916-442-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CAPITOL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165721",
            "telephone_number": "916-442-4985",
            "fax_number": "916-442-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C O R E MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "STENSON",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_title_or_position": "BUSINESS SERVICES DIRECTOR",
        "authorized_official_telephone_number": "916-442-4985"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Denise Byrne
• Lisa Marie Byrne, BCBA
• William Jonathan Byrne, PHARMD
• Jamie Lee Byrnes, RADT
• Jonathan Bystrynski, PHD
• C. Thaddeus Szymanowski, D.D.S, Inc. (Campus Commons Periodontics)
• C.O.N.R., Inc.
• C.S Crescent Solutions LLC
• C&B Family Corporation (B.E.Y.A. Leader Mentoring Program)
• Phuong P Ca

• Methadone Clinic in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Methadone Clinic in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.