Organization Active NPI

Visalia Women'S Specialty Medical Group, Inc

  • Obstetrics & Gynecology Physician
  • Visalia, CA
National Provider Identifier
1386709202
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
VISALIA WOMEN'S SPECIALTY MEDICAL GROUP, INC
Practice address
1700 S Court St
Suite B
Visalia, CA 93277-4929
Phone
(559) 741-1202
Fax
(559) 741-0123
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Authorized official

Name
Dr. Andrea B Boone, MDNPI 1528016235
Title
Owner
Phone
(559) 741-1202

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1700 S Court St
Suite B
Visalia, CA 93277-4929

Mailing address

1700 S Court St
Suite B
Visalia, CA 93277-4929
Phone (559) 741-1202

Other identifiers 1

IdentifierTypeStateIssuer
GR0080010MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050414000868 CA Part B Supplier - Clinic/Group Practice 7517904188 Receives reassigned benefits from 3 practitioners
Practice locations: Visalia, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0930567Visalia Womens Specialty Medical Group1700 S Court Street, Suite B, Visalia, CA 93277Provider-performed microscopyJul 14, 2027

National Provider Directory

National Provider Directory

Locations

1700 S Court St
Ste Bste
Visalia, CA 93277

1700 S Court St
Ste B
Visalia, CA 93277
Phone (559) 741-1202

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756684800000",
    "number": "1386709202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S COURT ST",
            "address_2": "SUITE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774929",
            "telephone_number": "559-741-1202",
            "fax_number": "559-741-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S COURT ST",
            "address_2": "SUITE B",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932774929",
            "telephone_number": "559-741-1202",
            "fax_number": "559-741-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISALIA WOMEN'S SPECIALTY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-741-1202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0080010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.