NPIMap

Individual provider Active NPI

Lamarr Echols

  • Emergency Medicine Physician
  • Fairfield, CA
National Provider Identifier
1770970139
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A148156 Issued in CA
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone
(707) 646-5652
NPI assigned
Apr 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A148156 CA Primary

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533

Mailing address

4425 17TH St
San Francisco, CA 94114-1806

Other practice location 1

7101 Joy St
Apt H8
Pensacola, FL 32504-6479
Phone (850) 980-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191031002609 CA Practitioner - Emergency Medicine 9739453283 Reassigns benefits to 3 organizations
I20200330003899 TX Practitioner - Emergency Medicine 9739453283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 429-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A148156CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince May 17, 2021 Accepting new patients
Providence Medical Foundation CurrentSince May 17, 2021 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
Providence Medical Foundation Current Accepting new patients
Solano Gateway Medical Group Inc Emergency Medicine CurrentSince Sep 1, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2019 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jan 27, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1770970139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 17TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-646-5652"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7101 Joy St",
            "address_2": "Apt H8",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325046479",
            "country_code": "US",
            "telephone_number": "850-980-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHOLS",
        "first_name": "LAMARR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A148156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.