Active NPI
Daniel Alan Nash, MD
- Sports Medicine (Family Medicine) Physician
- Ukiah, CA
National Provider Identifier
1629174909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- 21712
- Practice address
- 630 Kings Court
Ukiah, CA 95482 - Phone
- (707) 468-7700
- Fax
- (707) 468-7733
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 21712 | AZ | Primary |
Addresses
Primary practice location
630 Kings Court
Ukiah, CA 95482
Mailing address
630 Kings Court
Ukiah, CA 95482
Phone (707) 468-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130415000336 | CA | Order and Referring Only - Family Practice | 3274779434 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21712 | AZ | MD | Sports Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629174909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 KINGS COURT",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482",
"telephone_number": "707-468-7700",
"fax_number": "707-468-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 KINGS COURT",
"city": "UKIAH",
"state": "CA",
"postal_code": "95482",
"telephone_number": "707-468-7700",
"fax_number": "707-468-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "DANIEL",
"middle_name": "ALAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "AZ",
"license": "21712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.