NPIMap

Organization Active NPI

Keith F Korver MD a Professional Medical Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Santa Rosa, CA
National Provider Identifier
1508934845
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
G0522350 Issued in CA
Legal business name
KEITH F KORVER MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
3536 Medocino Avenue Suite 200
Santa Rosa, CA 95403
Phone
(707) 573-6166
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Keith KorverNPI 1316946130
Title
President
Phone
(707) 569-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X G0522350 CA Primary

Addresses

Primary practice location

3536 Medocino Avenue Suite 200
Santa Rosa, CA 95403

Mailing address

3510 Unocal PL Ste 207
Santa Rosa, CA 95403-0918
Phone (707) 569-7860

National Provider Directory

National Provider Directory
Tax ID family
Keith F Korver MD Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1017 El Camino Real
#361
Redwood City, CA 94063

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1508934845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 UNOCAL PL STE 207",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954030918",
            "telephone_number": "707-569-7860",
            "fax_number": "707-545-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 MEDOCINO AVENUE SUITE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95403",
            "telephone_number": "707-573-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH F KORVER MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "KORVER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-569-7860"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G0522350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.