NPIMap

Organization Active NPI

Family Care Providers Medical Group,Inc

  • Pediatrics Physician
  • Fresno, CA
National Provider Identifier
1689759565
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FAMILY CARE PROVIDERS MEDICAL GROUP,INC
Practice address
1300 N Fresno St
Fresno, CA 93703-3845
Phone
(559) 495-6702
Fax
(559) 495-6781
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kimberly McKenney
Title
Administrator
Phone
(559) 495-6758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1300 N Fresno St
Fresno, CA 93703-3845

Mailing address

1300 N Fresno St
Fresno, CA 93703-3845
Phone (559) 495-6702

Other identifiers 1

IdentifierTypeStateIssuer
00AX59230MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Family Care Prov Med GRP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689759565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033845",
            "telephone_number": "559-495-6702",
            "fax_number": "559-495-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937033845",
            "telephone_number": "559-495-6702",
            "fax_number": "559-495-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE PROVIDERS MEDICAL GROUP,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCKENNEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "559-495-6758",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX59230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.