Organization Active NPI

Adventist Health California Medical Group, Inc.

  • Cardiovascular Disease Physician
  • Saint Helena, CA
National Provider Identifier
1457648271
Registry record updated Jun 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.
Practice address
6 Woodland Rd
Suite 103
Saint Helena, CA 94574-9501
Phone
(707) 968-9622
Fax
(707) 968-9603
NPI assigned
Jun 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2011

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

Authorized official

Name
Kaye A. Donnelly
Title
Specialist, Contract Compliance
Phone
(707) 968-2809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

6 Woodland Rd
Suite 103
Saint Helena, CA 94574-9501

Mailing address

1001 Adams St
Suite 102
Saint Helena, CA 94574-1107
Phone (707) 968-2809

National Provider Directory

National Provider Directory
Tax ID family
Adventist Health California Medical Group Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1457648271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ADAMS ST",
            "address_2": "SUITE 102",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945741107",
            "telephone_number": "707-968-2809",
            "fax_number": "707-963-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "address_2": "SUITE 103",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749501",
            "telephone_number": "707-968-9622",
            "fax_number": "707-968-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH CALIFORNIA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SPECIALIST, CONTRACT COMPLIANCE",
        "authorized_official_telephone_number": "707-968-2809"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.