Individual provider Active NPI

Cavan Quam, FNP

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1801630058
Registry record updated Jun 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030658 Issued in CA
Practice address
8110 Timberlake Way
Sacramento, CA 95823-5401
Phone
(916) 689-4111
NPI assigned
Jun 22, 2024
Last updated
Jun 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030658 CA Primary

Addresses

Primary practice location

8110 Timberlake Way
Sacramento, CA 95823-5401

Mailing address

73 52ND St
Sacramento, CA 95819-2307
Phone (530) 570-1812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240812000997 CA Practitioner - Nurse Practitioner 9537607312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Family Physicians Inc CurrentSince Jul 1, 2024 Accepting new patients

Locations

8110 Timberlake Way
Sacramento, CA 95823
Phone (916) 250-0377

Interoperability endpoints

  • Direct secure messaging: cquam225347@hpmg.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1801630058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 52ND ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958192307",
            "telephone_number": "530-570-1812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 TIMBERLAKE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235401",
            "telephone_number": "916-689-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAM",
        "first_name": "CAVAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.