Ukiah Valley Primary Care Medical Group, Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/fdd8a9ae-8fbb-4d2d-bbc0-da474abde02e/

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janusz J Madej, M.D.

  • Internal Medicine Physician
  • Los Altos, CA
  • NPI 1376616706
  NPD (past)
• Erin E Thurman, PA

  • Medical Physician Assistant
  • Lakeport, CA
  • NPI 1053503144
  NPD (past)

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067100",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM03947G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPT000830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ukiah Obstetrics and Gynecology
• Ukiah Senior Center
• Ukiah Senior Center Inc.
• Ukiah Surgery Center LP
• Ukiah Valley Anesthesia Services
• Ukiah Valley Primary Care Medical Group, Inc
• Jason Don Ullyott, PA
• Melanie Ann Ulvila, LCSW
• Heylee Unangst
• Sabra Underwood

• Multi-Specialty Clinic/Center in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Multi-Specialty Clinic/Center in California

• 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.

Verify at the official NPI Registry.