Active NPI
Ukiah Valley Primary Care Medical Group, Inc
- Multi-Specialty Clinic/Center
- Ukiah, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- UKIAH VALLEY PRIMARY CARE MEDICAL GROUP, INC
- Practice address
- 260 Hospital Dr. Ste. 207
Ukiah, CA 95482-4533 - Phone
- (707) 463-8000
- Fax
- (707) 462-1111
- NPI assigned
- Dec 6, 2005
- Last updated
- Jun 3, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeremy Mann, M.D.
- Title
- President, Board of Directors
- Phone
- (707) 463-8000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
260 Hospital Dr. Ste. 207
Ukiah, CA 95482-4533
Mailing address
PO Box 2739
Ukiah, CA 95482-2739
Phone (707) 463-8000
National Provider Directory
National Provider DirectoryLocations
850 Sequoia Cir
Fort Bragg, CA 95437
Phone (707) 462-1928
487 S Main St
Ste 122
Lakeport, CA 95453
Phone (707) 263-4360
5150 Hill Rd E
Ste E
Lakeport, CA 95453
Phone (707) 263-4263
1050 N State St
Ukiah, CA 95482
Phone (707) 463-7488
1165 S Dora St
Ste A3
Ukiah, CA 95482
1165 S Dora St
Ste E1
Ukiah, CA 95482
1165 S Dora St
Ste F
Ukiah, CA 95482
1165 S Dora St
Ste G1
Ukiah, CA 95482
Phone (707) 468-0491
260 Hospital Dr
#203
Ukiah, CA 95482
620 S Dora St
Ste 204
Ukiah, CA 95482
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/fdd8a9ae-8fbb-4d2d-bbc0-da474abde02e/
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pediatrics Physician
- Ukiah, CA
- NPI 1831173632
-
- Internal Medicine Physician
- Los Altos, CA
- NPI 1376616706
-
- Medical Physician Assistant
- Lakeport, CA
- NPI 1053503144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1243987200000",
"number": "1699759332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2739",
"city": "UKIAH",
"state": "CA",
"postal_code": "954822739",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 HOSPITAL DR. STE. 207",
"city": "UKIAH",
"state": "CA",
"postal_code": "954824533",
"telephone_number": "707-463-8000",
"fax_number": "707-462-1111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UKIAH VALLEY PRIMARY CARE MEDICAL GROUP, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-06",
"last_updated": "2009-06-03",
"status": "A",
"authorized_official_last_name": "MANN",
"authorized_official_first_name": "JEREMY",
"authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
"authorized_official_telephone_number": "707-463-8000",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.