Active NPI
Annette Ndagano, MD
- Pediatrics Physician
- Red Bluff, CA
National Provider Identifier
1700978467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C53487
- Practice address
- 2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356 - Phone
- (530) 527-0414
- Fax
- (530) 528-4423
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C53487 | CA | Primary |
Addresses
Primary practice location
2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Mailing address
2450 Sister Mary Columba Dr
Red Bluff, CA 96080-4356
Phone (530) 527-0414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0016477840002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53487 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1700978467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2450 SISTER MARY COLUMBA DR",
"city": "RED BLUFF",
"state": "CA",
"postal_code": "960804356",
"telephone_number": "530-527-0414",
"fax_number": "530-528-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2450 SISTER MARY COLUMBA DR",
"city": "RED BLUFF",
"state": "CA",
"postal_code": "960804356",
"telephone_number": "530-527-0414",
"fax_number": "530-528-4423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NDAGANO",
"first_name": "ANNETTE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C53487",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0016477840002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bluff, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.