Central Coast Otolaryngology

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

CENTRAL COAST OTOLARYNGOLOGY

Doing business as

Sleep Disorders Center of Santa Maria

Practice address

116 S Palisade Dr
Suite 206
Santa Maria, CA 93454-8904

Phone

(805) 614-9250

NPI assigned

Oct 1, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Wikholm

Title

Office Manager

Phone

(805) 614-9250

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Sleep Disorders Center of Santa Maria Doing business as
• Richard P Wikholm MD, Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Central Coast Otolaryngology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Coast Otolaryngology

  • Medical Specialty Clinic/Center
  • Santa Maria, CA
  • NPI 1043623960
  NPD tax ID

Locations

Practitioners 4

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.

• Jennifer Renee Perry, AUD

  • Audiologist-Hearing Aid Fitter
  • Santa Maria, CA
  • NPI 1780938944
  Medicare reassignment Care Compare group NPD
• Richard P Wikholm, MD

  • Otolaryngology Physician
  • Santa Maria, CA
  • NPI 1831198647
  Medicare reassignment Care Compare group NPD
• Yi-Hsin Tai, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Santa Maria, CA
  • NPI 1265749329
  NPD (past)
• Rebekah Zaborowski, AU.D.

  • Audiologist
  • Cheyenne, WY
  • NPI 1538326236
  NPD (past)

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1427382811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR",
            "address_2": "STE 206",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548904",
            "telephone_number": "805-614-9250",
            "fax_number": "805-614-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S PALISADE DR",
            "address_2": "SUITE 206",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548904",
            "telephone_number": "805-614-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST OTOLARYNGOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "WIKHOLM",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "805-614-9250",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CL711A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Disorders Center of Santa Maria",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sleep Disorders Center of Santa Maria",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Richard P Wikholm MD, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Central Coast Medical Oncology Corp
• Central Coast Nursing Home Physicians, Inc. (NextGen Concierge Medicine)
• Central Coast Obstetrics and Gynecology
• Central Coast Orthopedic Medical Group
• Central Coast Otolaryngology
• Central Coast Portable Imaging Inc
• Central Coast Treatment Centers
• Central Coast Trstment Center
• Central Coast Urgent Care Medical Group
• Cep America - California

• Otolaryngology Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.