Organization Active NPI

Norcross Family Medicine, Inc.

  • Family Medicine Physician
  • Rolling Hills Estates, CA
National Provider Identifier
1457574519
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORCROSS FAMILY MEDICINE, INC.
Practice address
65A Peninsula Center
Rolling Hills Estates, CA 90274-3808
Phone
(310) 541-8919
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Authorized official

Name
Dr. Gwenne Norcross, D.O.NPI 1972608438
Title
President
Phone
(310) 541-8919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

65A Peninsula Center
Rolling Hills Estates, CA 90274-3808

Mailing address

65A Peninsula Ctr
Rolling Hills Estates, CA 90274-3506
Phone (310) 541-8919

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071024000585 CA Part B Supplier - Clinic/Group Practice 1355438284 Receives reassigned benefits from 2 practitioners
Practice locations: Rolling Hills Estates, CA

National Provider Directory

National Provider Directory

Locations

65A Peninsula Ctr
Rolling Hills Estates, CA 90274
Phone (310) 541-8919

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1457574519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65A PENINSULA CTR",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743506",
            "telephone_number": "310-541-8919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65A PENINSULA CENTER",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743808",
            "telephone_number": "310-541-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORCROSS FAMILY MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "NORCROSS",
        "authorized_official_first_name": "GWENNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-541-8919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.