NPIMap

Organization Active NPI

River City Medical Group, Inc.

  • Family Medicine Physician
  • Rancho Cordova, CA
National Provider Identifier
1609984202
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
100377 Issued in CA
Legal business name
RIVER CITY MEDICAL GROUP, INC.
Practice address
10390 Coloma Rd
Suite B
Rancho Cordova, CA 95670-2152
Phone
(916) 363-2229
Fax
(916) 363-2440
NPI assigned
Aug 25, 2006
Organization subpart
Yes
Parent organization
RIVER CITY MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Authorized official

Name
Mr. Kendrick Que
Title
Administrator
Phone
(916) 228-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 100377 CA Primary

Addresses

Primary practice location

10390 Coloma Rd
Suite B
Rancho Cordova, CA 95670-2152

Mailing address

PO Box 15470
Sacramento, CA 95851-0470
Phone (916) 228-4300

Other identifiers 1

IdentifierTypeStateIssuer
GR0053754MedicaidCA

Other names 1

  • Sacramento Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
River City Medical Group Inc9 organizations share this tax ID, including this one
Part of
River City Medical Group Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459468800000",
    "number": "1609984202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15470",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958510470",
            "telephone_number": "916-228-4300",
            "fax_number": "916-382-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10390 COLOMA RD",
            "address_2": "SUITE B",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702152",
            "telephone_number": "916-363-2229",
            "fax_number": "916-363-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVER CITY MEDICAL GROUP, INC.",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-04-01",
        "status": "A",
        "authorized_official_last_name": "QUE",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-228-4300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "100377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053754",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacramento Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; 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.