NPIMap

Organization Active NPI

Av Corp Inc

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1376223024
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AV CORP INC
Doing business as
Av Corp Inc
Practice address
4568 Feather River Dr Ste D
Stockton, CA 95219-6508
Phone
(734) 776-7889
NPI assigned
Jul 18, 2023
Last updated
Jul 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Authorized official

Name
Dr. Atul VermaNPI 1093027989
Title
Medical Dircetor
Phone
(734) 776-7889

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4568 Feather River Dr Ste D
Stockton, CA 95219-6508

Mailing address

9837 Kapalua LN
Elk Grove, CA 95624-5003
Phone (734) 776-7889

Other names 1

  • AV CORP INC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231011001883 CA Part B Supplier - Clinic/Group Practice 7416302401 Receives reassigned benefits from 5 practitioners
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1376223024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9837 KAPALUA LN",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245003",
            "telephone_number": "734-776-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4568 FEATHER RIVER DR STE D",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196508",
            "telephone_number": "734-776-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AV CORP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "VERMA",
        "authorized_official_first_name": "ATUL",
        "authorized_official_title_or_position": "MEDICAL DIRCETOR",
        "authorized_official_telephone_number": "734-776-7889",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AV CORP INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.