Organization Active NPI

Plastic Surgery Associates of Redding a Medical Corporation

  • Plastic Surgery Physician
  • Redding, CA
National Provider Identifier
1710035035
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY ASSOCIATES OF REDDING A MEDICAL CORPORATION
Practice address
2439 Sonoma St
Suite 101
Redding, CA 96001-3026
Phone
(530) 241-1300
Fax
(530) 241-0200
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Dr. Mark D Ball, MD
Title
President
Phone
(530) 241-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2439 Sonoma St
Suite 101
Redding, CA 96001-3026

Mailing address

2439 Sonoma St
Suite 101
Redding, CA 96001-3026
Phone (530) 241-1300

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ37414ZOtherCAMEDICARE GROUP ID
GR0057070MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1710035035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2439 SONOMA ST",
            "address_2": "SUITE 101",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013026",
            "telephone_number": "530-241-1300",
            "fax_number": "530-241-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2439 SONOMA ST",
            "address_2": "SUITE 101",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013026",
            "telephone_number": "530-241-1300",
            "fax_number": "530-241-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY ASSOCIATES OF REDDING A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-241-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "ZZZ37414Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.