NPIMap

Organization Active NPI

Ridge Medical Group Inc.

  • Family Medicine Physician
  • Grass Valley, CA
National Provider Identifier
1386700649
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G37527 Issued in CA
Legal business name
RIDGE MEDICAL GROUP INC.
Practice address
10565 Brunswick Rd
Suite 1
Grass Valley, CA 95945-9053
Phone
(530) 272-0501
Fax
(530) 272-0571
NPI assigned
Dec 29, 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
John C Jackson, MDNPI 1487689840
Title
MD
Phone
(530) 272-0501

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 G37527 CA Primary

Addresses

Primary practice location

10565 Brunswick Rd
Suite 1
Grass Valley, CA 95945-9053

Mailing address

10565 Brunswick Rd
Suite 1
Grass Valley, CA 95945-9053
Phone (530) 272-0501

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386700649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10565 BRUNSWICK RD",
            "address_2": "SUITE 1",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459053",
            "telephone_number": "530-272-0501",
            "fax_number": "530-272-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10565 BRUNSWICK RD",
            "address_2": "SUITE 1",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459053",
            "telephone_number": "530-272-0501",
            "fax_number": "530-272-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "530-272-0501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G37527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, 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.