NPIMap

Organization Active NPI

Regents of the Univ of Ca

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1386662716
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
REGENTS OF THE UNIV OF CA
Practice address
4860 Y St
Sacramento, CA 95817
Phone
(916) 734-6967
Fax
(916) 452-9327
NPI assigned
Jul 17, 2006
Last updated
Mar 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIV OF CAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Authorized official

Name
Mr. James D Kirk, MD
Title
Cmo
Phone
(916) 734-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

4860 Y St
Sacramento, CA 95817

Mailing address

4900 Broadway
Suite 2600
Sacramento, CA 95820
Phone (916) 734-9200

Other identifiers 1

IdentifierTypeStateIssuer
GSD003030MedicaidCA

Other names 1

  • Regents UCDPBG Optometry Other name

National Provider Directory

National Provider Directory
Tax ID family
Im General Medprof GP57 organizations share this tax ID, including this one
Part of
Im General Medprof GP

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1386662716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROADWAY",
            "address_2": "SUITE 2600",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95820",
            "telephone_number": "916-734-9200",
            "fax_number": "916-734-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 Y ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-6967",
            "fax_number": "916-452-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIV OF CA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIV OF CA",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "916-734-1166",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD003030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regents UCDPBG Optometry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.