Organization Active NPI

North Coast ENT Associates Inc

  • Otolaryngology Physician
  • Arcata, CA
National Provider Identifier
1649248063
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
NORTH COAST ENT ASSOCIATES INC
Practice address
3770 Janes Rd
Arcata, CA 95521-4744
Phone
(707) 822-5020
Fax
(707) 822-1969
NPI assigned
Mar 10, 2006
Last updated
Feb 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Authorized official

Name
Kristin Avila
Title
Billing Coordinator
Phone
(707) 822-5020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

3770 Janes Rd
Arcata, CA 95521-4744

Mailing address

3770 Janes Rd
Arcata, CA 95521-4744
Phone (707) 822-5020

Other identifiers 1

IdentifierTypeStateIssuer
GR0056090OtherCAMEDI-CAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1649248063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214744",
            "telephone_number": "707-822-5020",
            "fax_number": "707-822-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214744",
            "telephone_number": "707-822-5020",
            "fax_number": "707-822-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST ENT ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "707-822-5020"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0056090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.