Individual provider Active NPI

Cheri Quincy, D.O.

  • Internal Medicine Physician
  • Santa Rosa, CA
National Provider Identifier
1790877330
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A5137 Issued in CA
Practice address
2448 Guerneville Rd
Suite #400
Santa Rosa, CA 95403-4175
Phone
(707) 542-4800
Fax
(707) 542-0700
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A5137 CA Primary

Addresses

Primary practice location

2448 Guerneville Rd
Suite #400
Santa Rosa, CA 95403-4175

Mailing address

2448 Guerneville Rd
Suite #400
Santa Rosa, CA 95403-4175
Phone (707) 542-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Aug 6, 2011 through Aug 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5137CAMDAddiction (Substance Use Disorder) Counselor
20A5137CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Rim Integrated Medical Group Inc Internal Medicine PastSince Nov 1, 2007 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.

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": "1183852800000",
    "number": "1790877330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 GUERNEVILLE RD",
            "address_2": "SUITE #400",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954034175",
            "telephone_number": "707-542-4800",
            "fax_number": "707-542-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 GUERNEVILLE RD",
            "address_2": "SUITE #400",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954034175",
            "telephone_number": "707-542-4800",
            "fax_number": "707-542-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINCY",
        "first_name": "CHERI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A5137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.