NPIMap

Organization Active NPI

Rcoa-Adventist Health, LLC

Doing business as Adventist Health PET/CT - Sonora

  • Mobile Radiology Clinic/Center
  • Sonora, CA
National Provider Identifier
1376596742
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
6838-17 Issued in CA
Legal business name
RCOA-ADVENTIST HEALTH, LLC
Doing business as
Adventist Health PET/CT - Sonora
Practice address
1000 Greenley Rd
Sonora, CA 95370-5200
Phone
(866) 293-3500
Fax
(866) 293-3535
NPI assigned
May 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Derrick R Moore
Title
VP of Accounting and Finance
Phone
(561) 477-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 6838-17 CA Primary

Addresses

Primary practice location

1000 Greenley Rd
Sonora, CA 95370-5200

Mailing address

P. O. Box 85001
Orlando, FL 32885-0001
Phone (866) 293-3500

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ66592ZOtherCABS OF CA PROVIDER NUMBER

Other names 1

  • Adventist Health PET/CT - Sonora Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adventish Health Pet CT Kaweah Delta6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376596742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 85001",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850001",
            "telephone_number": "866-293-3500",
            "fax_number": "866-293-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREENLEY RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705200",
            "telephone_number": "866-293-3500",
            "fax_number": "866-293-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RCOA-ADVENTIST HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP OF ACCOUNTING AND FINANCE",
        "authorized_official_telephone_number": "561-477-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "CA",
            "license": "6838-17",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF CA PROVIDER NUMBER",
            "identifier": "ZZZ66592Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health PET/CT - Sonora",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.