Individual provider Active NPI

Joanna Jean Buchanan, DO

  • Pediatrics Physician
  • Folsom, CA
National Provider Identifier
1669976825
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
18335 Issued in CA
Practice address
1370 Prairie City Rd
Folsom, CA 95630-9554
Phone
(916) 985-9300
NPI assigned
Mar 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 18335 CA Primary

Addresses

Primary practice location

1370 Prairie City Rd
Folsom, CA 95630-9554

Mailing address

1370 Prairie City Rd
Folsom, CA 95630-9554
Phone (916) 985-9300

Other practice location 1

4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021
Phone (831) 818-7376

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
I20210929001758 CA Practitioner - Pediatric Medicine 7012314388 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Sep 1, 2021 Accepting new patients
Regents of the University of California CurrentSince Sep 1, 2021 Accepting new patients

Locations

14264 Innovation Dr
Folsom, CA 95630
Phone (916) 703-2486

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1669976825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 PRAIRIE CITY RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309554",
            "telephone_number": "916-985-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 PRAIRIE CITY RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309554",
            "telephone_number": "916-985-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4733 W Sunset Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276021",
            "country_code": "US",
            "telephone_number": "831-818-7376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "JOANNA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "18335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.