Nicodemus J. Garcia, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

104679 Issued in MO

Practice address

4550 Kearny Villa Rd
Ste. 116
San Diego, CA 92123-1578

Phone

(858) 279-1223

Fax

(858) 467-7161

NPI assigned

Jun 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1669478400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "STE. 116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-279-1223",
            "fax_number": "858-467-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "STE. 116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-279-1223",
            "fax_number": "858-467-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "NICODEMUS",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "104679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206935827",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalia Diaz Garcia
• Nayeli Garcia
• Neyra Garcia
• Nicholas Garcia
• Nicholas Garcia, D.C.
• Paola Lizett Garcia, FNP
• Paul Jude Garcia, P.T.A.
• Pauline Garcia
• Peter Garcia, DMD
• Philip Garcia, P.T

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.