Individual provider Active NPI

Vivi Robyn Stafford, MD

  • General Practice Physician
  • Lemoore, CA
National Provider Identifier
1437437761
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A85077 Issued in CA
Practice address
209 C St
Lemoore, CA 93245-2930
Phone
(559) 386-4500
Fax
(559) 282-5080
NPI assigned
Aug 3, 2011
Last updated
Sep 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A85077 CA Primary

Addresses

Primary practice location

209 C St
Lemoore, CA 93245-2930

Mailing address

539 Centennial Dr Apt a
Hanford, CA 93230-7460
Phone (323) 360-4670

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000257 CA Practitioner - Emergency MedicinePractitioner - Pain ManagementPractitioner - Addiction Medicine 4486829934 Reassigns benefits to 1 organization
Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Addiction Medicine, Pain Management
Education
University of Minnesota, Duluth School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State HospitalsGroup PAC ID 9638174238, 275 clinicians

Practice addresses (Care Compare)

24511 W Jayne Ave
Coalinga, CA 93210-9503
Phone (916) 651-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85077CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince Aug 13, 2023 Accepting new patients
Department of State Hospitals CurrentSince Aug 13, 2023 Accepting new patients

Locations

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1437437761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 CENTENNIAL DR APT A",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932307460",
            "telephone_number": "323-360-4670",
            "fax_number": "559-282-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 C ST",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932452930",
            "telephone_number": "559-386-4500",
            "fax_number": "559-282-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "VIVI",
        "middle_name": "ROBYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A85077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoore, CA

Sources for this page

Verify at the official NPI Registry.