Active NPI
Barbara Moon Showalter, MD
- Family Medicine Physician
- Merced, CA
National Provider Identifier
1669435947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G063855
- Practice address
- 2039 Canal St
Suite C
Merced, CA 95340-3726 - Phone
- (209) 723-7761
- Fax
- (209) 381-0322
- NPI assigned
- Apr 8, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G063855 | CA | Primary |
Addresses
Primary practice location
2039 Canal St
Suite C
Merced, CA 95340-3726
Mailing address
3144 G St
#125-334
Merced, CA 95340-1300
Phone (209) 723-7761
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770320287 | Other | CA | TAX ID |
| 00G638550 | Medicaid | CA |
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 |
|---|---|---|---|---|
| I20060601000183 | CA | Practitioner - Family Practice | 8820009087 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G063855 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timothy S. Johnston, M.D. PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237939200000",
"number": "1669435947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3144 G ST",
"address_2": "#125-334",
"city": "MERCED",
"state": "CA",
"postal_code": "953401300",
"telephone_number": "209-723-7761",
"fax_number": "209-381-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2039 CANAL ST",
"address_2": "SUITE C",
"city": "MERCED",
"state": "CA",
"postal_code": "953403726",
"telephone_number": "209-723-7761",
"fax_number": "209-381-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOWALTER",
"first_name": "BARBARA",
"middle_name": "MOON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-08",
"last_updated": "2009-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G063855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "770320287",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G638550",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Merced, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.