Organization Active NPI

Sonoma Pain Management, Inc

  • Neurology Physician
  • Petaluma, CA
National Provider Identifier
1386935039
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A778242 Issued in CA
Legal business name
SONOMA PAIN MANAGEMENT, INC
Practice address
1456 Professional Dr Ste 402
Petaluma, CA 94954-6639
Phone
(707) 938-7951
Fax
(707) 938-7260
NPI assigned
Apr 28, 2011
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Dr. Aimee C Chagnon, MCNPI 1548450448
Title
President
Phone
(707) 938-7951

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
Neurology Physician 2084N0400X A778242 CA Primary

Addresses

Primary practice location

1456 Professional Dr Ste 402
Petaluma, CA 94954-6639

Mailing address

1456 Professional Dr Ste 402
Petaluma, CA 94954-6639
Phone (707) 938-7951

Other names 1

  • Aimee C Chagnon, MD Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110823000494 CA Part B Supplier - Clinic/Group Practice 9234309683 Receives reassigned benefits from 2 practitioners
Practice locations: Petaluma, CA

National Provider Directory

National Provider Directory

Locations

1456 Professional Dr
Ste 402
Petaluma, CA 94954
Phone (707) 781-9566

181 Andrieux St
Ste 206
Sonoma, CA 95476
Phone (707) 938-7951

357 Perkins St
Sonoma, CA 95476
Phone (707) 935-5600

Practitioners & affiliated clinicians

Practitioners 6

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": "1303948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1386935039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DR STE 402",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546639",
            "telephone_number": "707-938-7951",
            "fax_number": "707-938-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DR STE 402",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949546639",
            "telephone_number": "707-938-7951",
            "fax_number": "707-938-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA PAIN MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-28",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "CHAGNON",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-938-7951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MC"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A778242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aimee C Chagnon, MD",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Aimee C Chagnon, MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.