Individual provider Active NPI

Charys Hayden-Town, NP

  • Primary Care Nurse Practitioner
  • Santa Rosa, CA
National Provider Identifier
1629697883
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95012198 Issued in CA
Practice address
1300 N Dutton Ave
Santa Rosa, CA 95401-7112
Phone
(707) 396-5151
NPI assigned
Apr 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 95012198 CA Primary

Addresses

Primary practice location

1300 N Dutton Ave
Santa Rosa, CA 95401-7112

Mailing address

1300 N Dutton Ave
Santa Rosa, CA 95401-7112
Phone (707) 396-5151

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201113001361 CA Practitioner - Nurse Practitioner 2062822414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1100 Trancas St
Suite 256
Napa, CA 94558-2921
Phone (707) 253-7161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as apm
Quality
84.3
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Community Health Centers CurrentSince Dec 2, 2022 Accepting new patients
Providence Medical Foundation CurrentSince Sep 3, 2024 Accepting new patients
Santa Rosa Community Health Centers Single Specialty Current Accepting new patients
Providence Medical Foundation Single Specialty Current Accepting new patients
Providence Medical Foundation Single Specialty CurrentSince Sep 3, 2024 Accepting new patients
Santa Rosa Community Health Centers CurrentSince Dec 2, 2022 Accepting new patients

Locations

1100 Trancas St
Ste 256
Napa, CA 94558
Phone (707) 253-7161

1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1300 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 303-3395

3569 Round Barn Cir
Santa Rosa, CA 95403

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1629697883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112",
            "telephone_number": "707-396-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954017112",
            "telephone_number": "707-396-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN-TOWN",
        "first_name": "CHARYS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95012198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.