Individual provider Active NPI

James Grant Fahey, PA-C

  • Physician Assistant
  • Citrus Heights, CA
National Provider Identifier
1417521006
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59574 Issued in CA
Practice address
7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133
Phone
(916) 536-3620
Fax
(916) 536-3541
NPI assigned
May 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59574 CA Primary

Addresses

Primary practice location

7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706003163 CA Practitioner - Physician Assistant 3577965052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1700 Prairie City Rd
Folsom, CA 95630-9594
Phone (916) 351-4800

1730 Prairie City Rd
Suite 120
Folsom, CA 95630-9594
Phone (916) 351-4800

3000 Q St
Sacramento, CA 95816-7058
Phone (916) 560-0319

Hospital & facility affiliations

  • Mercy General Hospital Hospital, Sacramento, CA, CCN 050017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA59574CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspace Health CurrentSince Jun 30, 2021 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Mar 3, 2025 Accepting new patients
Wellspace Health CurrentSince Jun 30, 2021 Accepting new patients
Wellspace Nexus PastSince May 1, 2021 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

7115 Greenback Ln
Fl 2
Citrus Heights, CA 95621
Phone (916) 536-3620

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

1820 J St
Sacramento, CA 95811
Phone (916) 550-5481

10423 Old Placerville Rd
Ste A
Sacramento, CA 95827
Phone (916) 569-8600

777 12th St
Ste 250
Sacramento, CA 95814
Phone (916) 469-4690

Interoperability endpoints

  • Direct secure messaging: james.fahey.p1@direct.wellspacehealth.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1417521006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 GREENBACK LN",
            "address_2": "FL 2",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956216133",
            "telephone_number": "916-536-3620",
            "fax_number": "916-536-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "JAMES",
        "middle_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2025-03-04",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.