NPIMap

Organization Active NPI

Supplmental Health Care

  • Exclusive Provider Organization
  • Modesto, CA
National Provider Identifier
1336433283
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
OT534 Issued in CA
Legal business name
SUPPLMENTAL HEALTH CARE
Practice address
1717 Marston Way
Modesto, CA 95355-1940
Phone
(209) 523-8745
NPI assigned
Jun 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Authorized official

Name
Ms. Susan Smith, OT
Title
Occupational Therapist
Phone
20952348745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X OT534 CA Primary

Addresses

Primary practice location

1717 Marston Way
Modesto, CA 95355-1940

Mailing address

1717 Marston Way
Modesto, CA 95355-1940
Phone (209) 523-8745

National Provider Directory

National Provider Directory
Tax ID family
Supplemental42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1336433283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 MARSTON WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551940",
            "telephone_number": "209-523-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MARSTON WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551940",
            "telephone_number": "209-523-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLMENTAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "20952348745",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "OT534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.