Organization Active NPI

Airell L Nygaard MD Inc

  • Physician Assistant
  • Sonora, CA
National Provider Identifier
1609062132
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18044 Issued in CA
Legal business name
AIRELL L NYGAARD MD INC
Practice address
680 Guzzi LN
Suite 102
Sonora, CA 95370-5288
Phone
(209) 588-1800
Fax
(209) 588-1700
NPI assigned
Sep 19, 2007
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Dr. Airell L Nygaard, MDNPI 1417920760
Title
President & Sole Owner
Phone
(209) 588-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18044 CA Primary

Addresses

Primary practice location

680 Guzzi LN
Suite 102
Sonora, CA 95370-5288

Mailing address

680 Guzzi LN
Suite 102
Sonora, CA 95370-5288
Phone (209) 588-1800

Other identifiers 1

IdentifierTypeStateIssuer
00C374790MedicaidCA

National Provider Directory

National Provider Directory

Locations

680 Guzzi Ln
Ste 102
Sonora, CA 95370
Phone (209) 536-5780

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1609062132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 GUZZI LN",
            "address_2": "SUITE 102",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705288",
            "telephone_number": "209-588-1800",
            "fax_number": "209-588-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 GUZZI LN",
            "address_2": "SUITE 102",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705288",
            "telephone_number": "209-588-1800",
            "fax_number": "209-588-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIRELL L NYGAARD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "NYGAARD",
        "authorized_official_first_name": "AIRELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT & SOLE OWNER",
        "authorized_official_telephone_number": "209-588-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C374790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.

Verify at the official NPI Registry.