NPIMap

Organization Active NPI

Dominican Hospital Foundation

  • Non-Pharmacy Dispensing Site
  • Santa Cruz, CA
National Provider Identifier
1548436983
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
G35500 Issued in CA
Legal business name
DOMINICAN HOSPITAL FOUNDATION
Practice address
1667 Dominican Way
134
Santa Cruz, CA 95065-1518
Phone
(831) 475-8834
NPI assigned
May 6, 2008
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X G35500 CA Primary

Addresses

Primary practice location

1667 Dominican Way
134
Santa Cruz, CA 95065-1518

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

National Provider Directory

National Provider Directory
Tax ID family
Dominican Hospital Foundation3 organizations share this tax ID, including this one
Part of
Tri - State Medical Group Inc

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1548436983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 DOMINICAN WAY",
            "address_2": "134",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651518",
            "telephone_number": "831-475-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINICAN HOSPITAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-05-06",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G35500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.