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)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

IdentifierTypeStateIssuer
PENDINGMedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 20, 2013.

{
    "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

All providers in Williams, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.