J Trees Ritter D.O., Inc.

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

J TREES RITTER D.O., INC.

Doing business as

Mic Ca

Practice address

1250 Peach St Ste M
San Luis Obispo, CA 93401-2877

Phone

(805) 540-0689

NPI assigned

Mar 26, 2019

Last updated

Dec 15, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

J TREES RITTER D.O., INC.As reported in NPPES

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

Authorized official

Name

Jethro Trees Ritter, DONPI 1457330797

Title

President

Phone

(805) 305-5296

Specialties & licenses 1

Addresses

Other names 1

• MIC CA Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• J Trees Ritter, DO, Inc.

  dba Central Coast ID Consultants

  • Infectious Disease Physician
  • San Luis Obispo, CA
  • NPI 1679772867

  O20070723000803

  Same enrollment

Part of

J Trees Ritter DO Inc

Locations

Practitioners 2

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.

• Jethro Trees Ritter, D.O.

  • Infectious Disease Physician
  • San Luis Obispo, CA
  • NPI 1457330797
  Authorized official Same address or phone
• Gregory Scott Canfield, M.D., PH.D.

  • Infectious Disease Physician
  • San Luis Obispo, CA
  • NPI 1144632159
  NPD

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1356802128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1206",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931161206",
            "telephone_number": "805-964-3838",
            "fax_number": "805-638-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PEACH ST STE M",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012877",
            "telephone_number": "805-540-0689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24640 Jefferson Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925629027",
            "country_code": "US",
            "telephone_number": "877-448-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17768 Wika Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923071200",
            "country_code": "US",
            "telephone_number": "877-448-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J TREES RITTER D.O., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "J TREES RITTER D.O., INC.",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "JETHRO",
        "authorized_official_middle_name": "TREES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-305-5296",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIC CA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MIC CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn Lynn Ison
• Amira E Issa, PC, BA
• Gibar Iturbide Colin
• Alex Joseph Iversen
• J Dustin Bernard DO Medical Corporation
• J Trees Ritter, DO, Inc. (Central Coast ID Consultants)
• Jac W Pedersen II DDS
• Jac W. Pedersen II, D.D.S., Inc
• Sarah Jackson
• Ava Blue Jacobsen

• Infusion Therapy Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Infusion Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.