Individual provider Active NPI

Robert K Garrison, M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1548313232
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G40594 Issued in CA
Practice address
168 N Brent St
Ste 502
Ventura, CA 93003-2817
Phone
(805) 641-2000
Fax
(805) 653-1644
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G40594 CA Primary

Addresses

Primary practice location

168 N Brent St
Ste 502
Ventura, CA 93003-2817

Mailing address

168 N Brent St
Ste 502
Ventura, CA 93003-2817
Phone (805) 641-2000

Other identifiers 1

IdentifierTypeStateIssuer
00G405940MedicaidCA

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
I20110510000039 CA Practitioner - Family Practice 9234105966 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince May 15, 2017 Accepting new patients
Sansum Clinic CurrentSince May 15, 2017 Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1548313232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST",
            "address_2": "STE 502",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032817",
            "telephone_number": "805-641-2000",
            "fax_number": "805-653-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST",
            "address_2": "STE 502",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032817",
            "telephone_number": "805-641-2000",
            "fax_number": "805-653-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "ROBERT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G40594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G405940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.