Individual provider Active NPI

Barbara Moon Showalter, MD

  • Family Medicine Physician
  • Merced, CA
National Provider Identifier
1669435947
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G063855 Issued in CA
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

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
770320287OtherCATAX ID
00G638550MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060601000183 CA Practitioner - Family Practice 8820009087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G063855CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.