Individual provider Active NPI

Reuben Sylvester Doggett, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Clovis, CA
National Provider Identifier
1477595395
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G41035 Issued in CA
Practice address
305 Park Creek Dr
Clovis, CA 93611-4426
Phone
(559) 326-2815
Fax
(559) 326-2801
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G41035 CA Primary

Addresses

Primary practice location

305 Park Creek Dr
Clovis, CA 93611-4426

Mailing address

PO Box 2130
Clovis, CA 93613-2130
Phone (559) 326-2815

Other identifiers 2

IdentifierTypeStateIssuer
220022684OtherRAILROAD MEDICARE
00G410350MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41035CAMDAnatomic Pathology & Clinical Pathology Physician
41035CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Pathology Laboratory Inc Current Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Crawford & Reiber Medical Associates Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

305 Park Creek Dr
Clovis, CA 93611
Phone (559) 326-2800

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1477595395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2130",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936132130",
            "telephone_number": "559-326-2815",
            "fax_number": "559-326-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 PARK CREEK DR",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114426",
            "telephone_number": "559-326-2815",
            "fax_number": "559-326-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOGGETT",
        "first_name": "REUBEN",
        "middle_name": "SYLVESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G41035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220022684",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G410350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.