Individual provider Active NPI

Richard Gregory Fourzon, D.C.

  • Chiropractor
  • Santa Rosa, CA
National Provider Identifier
1609086560
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0184090 Issued in CA
Practice address
585 West College Avenue
Suite: B
Santa Rosa, CA 95401-5060
Phone
(707) 579-2234
Fax
(707) 579-6001
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 18409 CA
Chiropractor 111N00000X DC0184090 CA Primary

Addresses

Primary practice location

585 West College Avenue
Suite: B
Santa Rosa, CA 95401-5060

Mailing address

585 West College Avenue
Suite: B
Santa Rosa, CA 95401-5060
Phone (707) 579-2234

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

State licenses

LicenseStateTypeSpecialty
DC0184090CAMDChiropractor
18409CAMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1609086560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 WEST COLLEGE AVENUE",
            "address_2": "SUITE: B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015060",
            "telephone_number": "707-579-2234",
            "fax_number": "707-579-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 WEST COLLEGE AVENUE",
            "address_2": "SUITE: B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015060",
            "telephone_number": "707-579-2234",
            "fax_number": "707-579-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURZON",
        "first_name": "RICHARD",
        "middle_name": "GREGORY",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "18409",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0184090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.