James Richard Pearson Jr., PAC
Individual provider Active NPI Medical Physician Assistant · Corning, CA
NPI 1598756942 · NPPES record last updated May 12, 2011
Key facts
- NPI
- 1598756942
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA12619 (CA)
- Practice address
- 155 Solano St
Corning Medical Associates Inc
Corning, CA 96021-3511 - Phone
- (530) 824-4663
- Fax
- (530) 824-5204
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080709000645 | CA | Practitioner - Physician Assistant | 0345312229 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12619 | CA | MD | Speech-Language Pathologist |
| PA12619 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontier Village Family Health Center, Inc | Current |
Accepting new patients | |
| Colusa Medical Center, LLC | Past | Accepting new patients |
Locations
645 Antelope Blvd
Ste 24
Red Bluff, CA 96080
Phone (530) 528-7650
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA12619 | CA | Yes |
Addresses
Primary practice location
155 Solano St
Corning Medical Associates Inc
Corning, CA 96021-3511
Mailing address
155 Solano St
Corning Medical Associates Inc
Corning, CA 96021-3511
Phone (530) 824-4663
Other providers in Corning, CA
- Olive City Pharmacy Inc
- James Peng Ooi
- Oroville Hospital
- Lesly Orozco-Sanchez
- Aimee Paya
- David Ruiz Perez
- Carla J Pharris
- Physical Therapy and Wellness Center--Corning, Inc.
- Angelica Maria Ramos
- Elisabeth Rave Dipietro
All providers in Corning, CA · Medical Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.