NPIMap

Individual provider Active NPI

Jared Daniel Garrison, D.O.

  • Family Medicine Physician
  • Willows, CA
National Provider Identifier
1689692865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8298 Issued in CA
Practice address
1133 W Sycamore St
Willows, CA 95988-2601
Phone
(530) 934-1816
Fax
(530) 934-1991
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 20A8298 CA Primary

Addresses

Primary practice location

1133 W Sycamore St
Willows, CA 95988-2601

Mailing address

1133 W Sycamore St
Willows, CA 95988-2601
Phone (530) 934-1816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070807000676 CA Practitioner - Family PracticePractitioner - General Practice 0941391866 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Glenn Medical Center, IncGroup PAC ID 3870505035, 13 clinicians
Glenn Medical Center, LLCGroup PAC ID 4486050838, shared by 3 NPIs, 13 clinicians

Practice addresses (Care Compare)

1133 W Sycamore St
Willows, CA 95988-2601
Phone (530) 934-1881

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8298CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC CurrentSince Jan 31, 2018 Accepting new patients
Glenn Medical Center, LLC CurrentSince Feb 2, 2018 Accepting new patients
Glenn Medical Center, LLC CurrentSince Oct 1, 2023 Accepting new patients
Willows Family Practice, Inc. Family Medicine Past Accepting new patients
Colusa Medical Center, LLC Past Accepting new patients
Colusa Medical Center, LLC Past Accepting new patients

Locations

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Red Bluff Healthcare CenterRed Bluff, CA, CCN 056274 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2019
Jan 1, 2019
Willows Post AcuteWillows, CA, CCN 555151 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 9, 2009
Dec 3, 2009

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689692865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 W SYCAMORE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882601",
            "telephone_number": "530-934-1816",
            "fax_number": "530-934-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 W SYCAMORE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882601",
            "telephone_number": "530-934-1816",
            "fax_number": "530-934-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "JARED",
        "middle_name": "DANIEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willows, CA

Sources for this page

Verify at the official NPI Registry.