Baychildren's Medical Group

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

BAYCHILDREN'S MEDICAL GROUP

Practice address

6475 Christie Ave
Suite 300
Emeryville, CA 94608-1095

Phone

(415) 476-7220

NPI assigned

Jan 16, 2015

Last updated

Jul 14, 2015By 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

Carolyn Appenzeller, RN, MSN

Title

Executive Director

Phone

(415) 476-7220

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1497144257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 CHRISTIE AVE",
            "address_2": "SUITE 300",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081095",
            "telephone_number": "415-476-7220",
            "fax_number": "415-353-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 CHRISTIE AVE",
            "address_2": "SUITE 300",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081095",
            "telephone_number": "415-476-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCHILDREN'S MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "APPENZELLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "415-476-7220",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.