Individual provider Active NPI

Cathi Lee Nanninga, MD

  • Hospitalist Physician
  • Los Angeles, CA
National Provider Identifier
1497744023
Registry record updated Nov 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
G045964 Issued in CA
Practice address
4727 Wilshire Blvd
Ste 100
Los Angeles, CA 90010
Phone
(323) 938-2942
Fax
(323) 938-8952
NPI assigned
Oct 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G045964 CA
Hospitalist Physician 208M00000X G045964 CA Primary

Addresses

Primary practice location

4727 Wilshire Blvd
Ste 100
Los Angeles, CA 90010

Mailing address

4727 Wilshire Blvd
Ste 100
Los Angeles, CA 90010
Phone (323) 938-2942

Other identifiers 1

IdentifierTypeStateIssuer
00G0459640MedicaidCA

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
G045964CAMDHospitalist Physician

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509494400000",
    "number": "1497744023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 WILSHIRE BLVD",
            "address_2": "STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90010",
            "telephone_number": "323-938-2942",
            "fax_number": "323-938-8952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 WILSHIRE BLVD",
            "address_2": "STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90010",
            "telephone_number": "323-938-2942",
            "fax_number": "323-938-8952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNINGA",
        "first_name": "CATHI",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2017-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G045964",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "G045964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G0459640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.