Organization Active NPI

Sutter Medical Group of the Redwoods

  • Pediatrics Physician
  • Santa Rosa, CA
National Provider Identifier
1407970544
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SUTTER MEDICAL GROUP OF THE REDWOODS
Practice address
1200 Sonoma Ave
Suite 6
Santa Rosa, CA 95405-6664
Phone
(707) 545-2545
Fax
(707) 545-1829
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Linda E Rockstroh
Title
Credentialing Specialist
Phone
(707) 521-8809

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X CA Primary
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X CA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X CA

Addresses

Primary practice location

1200 Sonoma Ave
Suite 6
Santa Rosa, CA 95405-6664

Mailing address

3883 Airway Dr
Santa Rosa
Santa Rosa, CA 95403-1670
Phone (707) 521-8809

National Provider Directory

National Provider Directory

Locations

3883 Airway Dr
Santa Rosa, CA 95403
Phone (415) 751-1817

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1407970544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "SANTA ROSA",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-521-8809",
            "fax_number": "707-521-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SONOMA AVE",
            "address_2": "SUITE 6",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056664",
            "telephone_number": "707-545-2545",
            "fax_number": "707-545-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROCKSTROH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "707-521-8809"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.