Organization Active NPI

North State Medical Primary Care, Inc.

  • Internal Medicine Physician
  • Chico, CA
National Provider Identifier
1366303174
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH STATE MEDICAL PRIMARY CARE, INC.
Practice address
274 Cohasset Rd Ste 110
Chico, CA 95926-2236
Phone
(530) 896-7455
Fax
(530) 896-1832
NPI assigned
Nov 20, 2025
Last updated
Feb 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Authorized official

Name
Edward T Wilson, D.O.NPI 1376921809
Title
Ceo/Cfo
Phone
(530) 896-7455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

274 Cohasset Rd Ste 110
Chico, CA 95926-2236

Mailing address

140 Amber Grove Dr Ste 143
Chico, CA 95973-5887
Phone (530) 896-7455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260213003409 CA Part B Supplier - Clinic/Group Practice 6507346095 Receives reassigned benefits from 2 practitioners
Practice locations: Chico, CA

National Provider Directory

National Provider Directory

Locations

140 Amber Grove Dr
Ste 143
Chico, CA 95973

274 Cohasset Rd
Chico, CA 95926
Phone (530) 891-0325

Practitioners & affiliated clinicians

Practitioners 3

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": "1763596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771286400000",
    "number": "1366303174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 AMBER GROVE DR STE 143",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959735887",
            "telephone_number": "530-896-7455",
            "fax_number": "530-896-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 COHASSET RD STE 110",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262236",
            "telephone_number": "530-896-7455",
            "fax_number": "530-896-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STATE MEDICAL PRIMARY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-20",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "530-896-7455",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; 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.