Individual provider Active NPI

Teresa Eileen North, P.A.-C

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1568460731
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 10502 Issued in CA
Practice address
5301 F St
Ste 111
Sacramento, CA 95819-3226
Phone
(916) 452-8291
Fax
(916) 452-1733
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 10502 CA Primary

Addresses

Primary practice location

5301 F St
Ste 111
Sacramento, CA 95819-3226

Mailing address

5301 F St
Ste 111
Sacramento, CA 95819-3226
Phone (916) 452-8291

Other identifiers 1

IdentifierTypeStateIssuer
GR0046820MedicaidCA

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 10502CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
LJ Wolff Medical Corporation Past Accepting new patients
Sacramento Cardiovascular Surgeons Medical Group Inc Physician Assistant Past Accepting new patients

Organizations & group practices 2

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1568460731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 F ST",
            "address_2": "STE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193226",
            "telephone_number": "916-452-8291",
            "fax_number": "916-452-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 F ST",
            "address_2": "STE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193226",
            "telephone_number": "916-452-8291",
            "fax_number": "916-452-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTH",
        "first_name": "TERESA",
        "middle_name": "EILEEN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 10502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.