Organization Active NPI

Elk Grove Cardiology Inc

  • Cardiovascular Disease Physician
  • Sacramento, CA
National Provider Identifier
1780220525
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ELK GROVE CARDIOLOGY INC
Practice address
8120 Timberlake Way Ste 210B
Sacramento, CA 95823-5414
Phone
(916) 251-3058
Fax
(916) 282-2441
NPI assigned
Nov 26, 2019
Last updated
Jan 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Chrystel Mower
Title
Practice Manager
Phone
(775) 622-7312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

8120 Timberlake Way Ste 210B
Sacramento, CA 95823-5414

Mailing address

8120 Timberlake Way Ste 210B
Sacramento, CA 95823-5414
Phone (916) 251-3058

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Sacramento Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191217000876 CA Part B Supplier - Clinic/Group Practice 8022442581 Receives reassigned benefits from 3 practitioners
Practice locations: Elk Grove, CA

National Provider Directory

National Provider Directory

Locations

8290 Elk Grove Blvd
Ste 100
Elk Grove, CA 95758
Phone (916) 251-3058

8120 Timberlake Way
Ste 210B
Sacramento, CA 95823
Phone (916) 251-3058

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1780220525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY STE 210B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235414",
            "telephone_number": "916-251-3058",
            "fax_number": "916-282-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY STE 210B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235414",
            "telephone_number": "916-251-3058",
            "fax_number": "916-282-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE CARDIOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "MOWER",
        "authorized_official_first_name": "CHRYSTEL",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "775-622-7312"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Sacramento",
            "affiliation": "N",
            "endpointDescription": "elk grove cardiology",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8120 Timberlake Way Ste 210B",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958235414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.