Active NPI
Patricia A Doplemore, NP
- Family Nurse Practitioner
- Stockton, CA
National Provider Identifier
1790741270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4611
- Practice address
- 2505 W Hammer LN
Stockton, CA 95209-2839 - Phone
- (209) 957-7050
- NPI assigned
- Apr 25, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4611 | CA | Primary |
| Registered Nurse | 163W00000X | 300814 | CA |
Addresses
Primary practice location
2505 W Hammer LN
Stockton, CA 95209-2839
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN244783 | Medicaid | CA |
Other names 1
- Patricia A Green
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4611 | CA | MD | Professional Counselor |
| 29419 | CA | MD | General Practice Dentistry |
| 300814 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Gould Medical Foundation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Turlock, CA
- NPI 1023065133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1790741270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-521-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 W HAMMER LN",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952092839",
"telephone_number": "209-957-7050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOPLEMORE",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "4611",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "300814",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RN244783",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PATRICIA",
"last_name": "GREEN",
"middle_name": "A",
"credential": "R.N",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.