NPIMap

Organization Active NPI

Sutter Medical Group of the Redwoods

  • Obstetrics & Gynecology Physician
  • Santa Rosa, CA
National Provider Identifier
1639268667
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25179 Issued in CA
Legal business name
SUTTER MEDICAL GROUP OF THE REDWOODS
Practice address
3317 Chanate Rd
Suite 2C
Santa Rosa, CA 95404-1737
Phone
(707) 570-1130
Fax
(707) 571-2478
NPI assigned
Oct 11, 2006
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Linda Rockstroh
Title
Credentialing Specialist
Phone
(707) 521-8809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 25179 CA Primary

Addresses

Primary practice location

3317 Chanate Rd
Suite 2C
Santa Rosa, CA 95404-1737

Mailing address

3883 Airway Dr
Suite 300
Santa Rosa, CA 95403-1670
Phone (707) 521-8809

Other identifiers 1

IdentifierTypeStateIssuer
GR0055426MedicaidCA

National Provider Directory

National Provider Directory

Locations

3317 Chanate Rd
Ste 2C
Santa Rosa, CA 95404
Phone (707) 570-1130

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1639268667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "SUITE 300",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-521-8809",
            "fax_number": "707-521-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 CHANATE RD",
            "address_2": "SUITE 2C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041737",
            "telephone_number": "707-570-1130",
            "fax_number": "707-571-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "ROCKSTROH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "707-521-8809"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "25179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0055426",
            "state": "CA"
        }
    ],
    "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 Apr 8, 2008; 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.