NPIMap

Organization Active NPI

Sutter Regional Medical Foundation

  • Mammography Clinic/Center
  • Fairfield, CA
National Provider Identifier
1487747333
Registry record updated Dec 4, 2007
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Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
Legal business name
SUTTER REGIONAL MEDICAL FOUNDATION
Practice address
2700 Low CT
Fairfield, CA 94534-9715
Phone
(707) 432-2500
Fax
(707) 432-2565
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Carolyn Appenzeller
Title
Chief Operating Officer
Phone
(707) 434-2049

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X
Mammography Clinic/Center 261QR0206X Primary

Addresses

Primary practice location

2700 Low CT
Fairfield, CA 94534-9715

Mailing address

PO Box 254978
Sacramento, CA 95865-4978

Other identifiers 1

IdentifierTypeStateIssuer
IDTF00410MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1487747333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 254978",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958654978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LOW CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349715",
            "telephone_number": "707-432-2500",
            "fax_number": "707-432-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER REGIONAL MEDICAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "APPENZELLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "707-434-2049"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTF00410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.