Active NPI
Richard Jeffrey Mize, M.D.
- Family Medicine Physician
- Crescent City, CA
National Provider Identifier
1548595697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G44645
- Practice address
- 1200 Marshall St
Crescent City, CA 95531-2217 - Phone
- (707) 465-1126
- Fax
- (707) 465-0937
- NPI assigned
- Oct 7, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G44645 | CA | Primary |
Addresses
Primary practice location
1200 Marshall St
Crescent City, CA 95531-2217
Mailing address
1200 Marshall St
Crescent City, CA 95531-2217
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
| License | State | Type | Specialty |
|---|---|---|---|
| G44645 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254873600000",
"number": "1548595697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 MARSHALL ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955312217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 MARSHALL ST",
"city": "CRESCENT CITY",
"state": "CA",
"postal_code": "955312217",
"telephone_number": "707-465-1126",
"fax_number": "707-465-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZE",
"first_name": "RICHARD",
"middle_name": "JEFFREY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-07",
"last_updated": "2009-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G44645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.