Mary Terese Dodd, FNP
Individual provider Active NPI Family Nurse Practitioner · Fortuna, CA
NPI 1386367381 · NPPES record last updated Sep 23, 2022
Key facts
- NPI
- 1386367381
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 95022687 (CA)
- Practice address
- 874 Main St
Fortuna, CA 95540-1926 - Phone
- (707) 725-3334
- Fax
- (707) 725-2455
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fortuna Family Medicine Inc
Practice addresses (Care Compare)
2404 Newburg Rd
Fortuna, CA 95540-2818
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230119002511 | CA | Practitioner - Nurse Practitioner | 4486025962 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GN Medical Associates, Inc. | Family | Current |
Accepting new patients |
| Altea Medical California PC | Current |
Accepting new patients | |
| Careconnectmd Ca PC | Current |
Accepting new patients | |
| Fortuna Family Medical Group Inc | Past |
Accepting new patients |
Locations
400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297
495 E Rincon St
Ste 105
Corona, CA 92879
Phone (888) 969-9808
3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182
2885 Harris St
Eureka, CA 95503
Phone (707) 441-8449
2321 Newburg Rd
Fortuna, CA 95540
Phone (707) 725-4457
5696 Lake Murray Blvd
La Mesa, CA 91942
Phone (619) 460-5225
517 S A St
Madera, CA 93638
Phone (559) 673-9228
2424 M St
Merced, CA 95340
Phone (209) 723-2442
2124 57th Ave
Oakland, CA 94621
Phone (510) 261-2628
39950 Vista del Sol
Rancho Mirage, CA 92270
Phone (760) 340-0053
1750 Montgomery St
Fl 1
San Francisco, CA 94111
Phone (714) 619-8777
3401 W Sunflower Ave
#250
Santa Ana, CA 92704
Phone (415) 848-8258
3000 N Gate Rd
Seal Beach, CA 90740
Phone (562) 594-5790
473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500
473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500
2005 River St
Susanville, CA 96130
Phone (530) 257-5341
13333 Fenton Ave
Sylmar, CA 91342
Phone (818) 367-1033
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95022687 | CA | Yes |
Addresses
Primary practice location
874 Main St
Fortuna, CA 95540-1926
Mailing address
PO Box 7306
Eureka, CA 95502-7306
Phone (707) 683-5073
Other providers in Fortuna, CA
- Dickerson Solution
- Dionysos Durand Dickerson
- Vanessa Nicole Dickerson
- Patricia Dillon
- Stephanie S Dittmer
- Tamara Smith Douglass
- Fannette Downie-Allman
- Clare Edwards
- Eel River Valley Surgical Group
- Kelly Ehrhardt
All providers in Fortuna, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.