NPIMap

Organization Active NPI

Capital Allergy and Respiratory Disease Center a Med Corp

  • Allergy Physician
  • Sacramento, CA
National Provider Identifier
1629191267
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
CAPITAL ALLERGY AND RESPIRATORY DISEASE CENTER A MED CORP
Practice address
5609 J Street
Suite C
Sacramento, CA 95819
Phone
(916) 453-8696
Fax
(916) 453-8715
NPI assigned
Apr 9, 2007
Last updated
Jun 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Shenna Dakin
Title
Billing Manager
Phone
(916) 233-2613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X CA Primary

Addresses

Primary practice location

5609 J Street
Suite C
Sacramento, CA 95819

Mailing address

1451 Secret Ravine Pkwy
Suite 150
Roseville, CA 95661
Phone (916) 453-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060123000400 CA Part B Supplier - Clinic/Group Practice 7113941709 Receives reassigned benefits from 10 practitioners
Practice locations: Roseville, CA; Folsom, CA

National Provider Directory

National Provider Directory

Locations

1451 Secret Ravine Pkwy
Ste 140
Roseville, CA 95661

5609 J St
Ste C
Sacramento, CA 95819
Phone (916) 453-8696

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1629191267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 SECRET RAVINE PKWY",
            "address_2": "SUITE 150",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-453-8696",
            "fax_number": "916-453-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5609 J STREET",
            "address_2": "SUITE C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95819",
            "telephone_number": "916-453-8696",
            "fax_number": "916-453-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL ALLERGY AND RESPIRATORY DISEASE CENTER A MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "DAKIN",
        "authorized_official_first_name": "SHENNA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "916-233-2613"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.