Individual provider Active NPI

Kathy L Head, M.D.

  • Occupational Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1528171600
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
A61758 Issued in CA
Practice address
525 3Rd Ave
Chula Vista, CA 91910-5616
Phone
(858) 526-6150
Fax
(858) 526-6153
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician 2083X0100X A61758 CA Primary

Addresses

Primary practice location

525 3Rd Ave
Chula Vista, CA 91910-5616

Mailing address

525 3Rd Ave
Chula Vista, CA 91910-5616
Phone (858) 526-6150

Other identifiers 1

IdentifierTypeStateIssuer
00A617580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111117000279 CA Practitioner - Preventive Medicine 1153595798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
University of New Mexico School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

16950 Via Tazon
San Diego, CA 92127-1607
Phone (858) 499-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A61758CAMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 4, 2011 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Sep 4, 2011 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients

Locations

525 Third Ave
Chula Vista, CA 91910
Phone (619) 585-4050

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

10243 Genetic Center Dr
San Diego, CA 92121
Phone (858) 499-2704

Interoperability endpoints

  • Direct secure messaging: khead24907@sharphealthcare.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1528171600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 3RD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105616",
            "telephone_number": "858-526-6150",
            "fax_number": "858-526-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 3RD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919105616",
            "telephone_number": "858-526-6150",
            "fax_number": "858-526-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "KATHY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "A61758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A617580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.