NPIMap

Organization Active NPI

Lodi Memorial Hospital Association Inc

Doing business as Lodi Memorial Surgical Group

  • Clinic/Center
  • Lodi, CA
National Provider Identifier
1396018727
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
Lodi Memorial Surgical Group
Practice address
999 S Fairmont Ave
Suite 100
Lodi, CA 95240-5100
Phone
(209) 334-2010
NPI assigned
Feb 15, 2012
Last updated
Oct 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Authorized official

Name
Mr. Joseph P Harrington
Title
Chief Executive Officer
Phone
(209) 334-3411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CA Primary

Addresses

Primary practice location

999 S Fairmont Ave
Suite 100
Lodi, CA 95240-5100

Mailing address

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Other names 1

  • LODI MEMORIAL SURGICAL GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000577 CA Part B Supplier - Clinic/Group Practice 7618880717 Receives reassigned benefits from 228 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, CA

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1396018727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE",
            "address_2": "SUITE 100",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405100",
            "telephone_number": "209-334-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "209-334-3411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LODI MEMORIAL SURGICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.