NPIMap

Organization Active NPI

Sutter Medical Group of the Redwoods

  • Urology Physician
  • Santa Rosa, CA
National Provider Identifier
1366628224
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SUTTER MEDICAL GROUP OF THE REDWOODS
Practice address
500 Doyle Park Dr
Ste. 303
Santa Rosa, CA 95405-4558
Phone
(707) 575-1833
Fax
(707) 575-1892
NPI assigned
Jan 10, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Linda E Rockstroh
Title
Credentialing Administrative Assist
Phone
(707) 521-8809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X CA Primary

Addresses

Primary practice location

500 Doyle Park Dr
Ste. 303
Santa Rosa, CA 95405-4558

Mailing address

3883 Airway Dr Ste 300
Santa Rosa, CA 95403-1671
Phone (707) 521-8809

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366628224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 300",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-521-8809",
            "fax_number": "707-521-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "STE. 303",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-575-1833",
            "fax_number": "707-575-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROCKSTROH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATIVE ASSIST",
        "authorized_official_telephone_number": "707-521-8809"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.