Coppertower Family Medical Center

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

COPPERTOWER FAMILY MEDICAL CENTER

Doing business as

Alexander Valley Healthcare

Practice address

6 Tarman Drive
Cloverdale, CA 95425-3932

Phone

(707) 894-4229

Fax

(707) 894-2954

NPI assigned

Feb 22, 2006

Last updated

Jun 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenine Saunders

Title

Cfo

Phone

(707) 894-4229

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Alexander Valley Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Coppertower Family Medical Center

  dba Alexander Valley Healthcare

  • Federally Qualified Health Center (FQHC)
  • Cloverdale, CA
  • NPI 1033534466

  O20031105000381

  Same enrollment

Locations

Practitioners 8

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.

• Angelica Andrade, MSW

  • Clinical Social Worker
  • Windsor, CA
  • NPI 1992080196
  NPD
• Ronald L Brown, M.D.

  • Allergy & Immunology Physician
  • Davis, CA
  • NPI 1538272257
  NPD
• Angelique Green, M.D.

  • General Practice Physician
  • Oakland, CA
  • NPI 1427269067
  NPD
• Harshpreet Kaur Khroud

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresno, CA
  • NPI 1063279776
  NPD
• David Lawrence Nunez, M.D.

  • Pediatrics Physician
  • Santa Ana, CA
  • NPI 1396047437
  NPD
• Kanwal Qidwai, MD

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Oakland, CA
  • NPI 1184980591

  Single Specialty

  NPD
• Joann Rosenfeld, MD

  • Family Medicine Physician
  • Angels Camp, CA
  • NPI 1215031588
  NPD
• Cheri Lynn Heffel, NP

  • Family Nurse Practitioner
  • Cloverdale, CA
  • NPI 1508833153
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1467427310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E 1ST ST",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253746",
            "telephone_number": "707-669-1780",
            "fax_number": "707-894-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TARMAN DRIVE",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954253932",
            "telephone_number": "707-894-4229",
            "fax_number": "707-894-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPERTOWER FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "JENINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-894-4229"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY FACT",
            "identifier": "HAP53824F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM53824G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN NUMBER",
            "identifier": "ZZZ47432Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alexander Valley Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alexander Valley Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine C Chu, L.AC.
• Cloverdale Counseling Center, Inc.
• Cloverdale Hospital District Ambulance
• Cloverdale Unified School District
• Coppertower Family Medical Center (Alexander Valley Healthcare)
• Coppertower Family Medical Center (alexander Valley healthcare)
• Coppertower Family Medical Center (Alexander Valley Healthcare)
• County of Sonoma
• Toby Daly, LAC
• Amu Xenaphon Darya, AGPCNP, CNS

• Rural Health Clinic/Center in Cloverdale, CA
• Providers in Cloverdale, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.