Jared D Garrison DO Inc
Organization Active NPI Family Medicine Physician · Williams, CA
NPI 1477974202 · NPPES record last updated Dec 20, 2013
Key facts
- NPI
- 1477974202
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20A8298 (CA)
- Legal business name
- JARED D GARRISON DO INC
- Practice address
- 1224 E St
Williams, CA 95987 - Phone
- (530) 473-5321
- Fax
- (530) 473-5172
- NPI assigned
- Dec 20, 2013
- Organization subpart
- No
Authorized official
- Name
- Jared D Garrison, DO
- Title
- DO/President
- Phone
- (530) 934-2834
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 20A8298 | CA | Yes |
Addresses
Primary practice location
1224 E St
Williams, CA 95987
Mailing address
PO Box 4581
Orland, CA 95963-4581
Phone (530) 898-1201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | CA |
NPI Registry JSON
{
"created_epoch": "1387497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387497600000",
"number": "1477974202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4581",
"city": "ORLAND",
"state": "CA",
"postal_code": "959634581",
"telephone_number": "530-898-1201",
"fax_number": "530-898-1204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 E ST",
"city": "WILLIAMS",
"state": "CA",
"postal_code": "95987",
"telephone_number": "530-473-5321",
"fax_number": "530-473-5172"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JARED D GARRISON DO INC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-20",
"last_updated": "2013-12-20",
"status": "A",
"authorized_official_last_name": "GARRISON",
"authorized_official_first_name": "JARED",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "DO/PRESIDENT",
"authorized_official_telephone_number": "530-934-2834",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "20A8298",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Williams, CA
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- Fouch & Son Pharmacy
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- Jazmin Lee Leos
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- Lexus Marthel
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All providers in Williams, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.