NPIMap

Organization Active NPI

Community Medical Providers Medical Group Inc

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1821075748
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G50552 Issued in CA
Legal business name
COMMUNITY MEDICAL PROVIDERS MEDICAL GROUP INC
Practice address
1180 E Shaw Ave
Ste 125
Fresno, CA 93710-7812
Phone
(559) 228-4200
Fax
(559) 224-3920
NPI assigned
Dec 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Grant Nakamura, MD
Title
Medical Director
Phone
(559) 228-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X G50552 CA Primary

Addresses

Primary practice location

1180 E Shaw Ave
Ste 125
Fresno, CA 93710-7812

Mailing address

PO Box 28900
Fresno, CA 93729
Phone (559) 228-4200

Other identifiers 7

IdentifierTypeStateIssuer
GR0068691MedicaidCA
GR0068696MedicaidCA
GR0068690MedicaidCA
GR0068695MedicaidCA
GR0068692MedicaidCA
GR0068693MedicaidCA
GR0068694MedicaidCA

National Provider Directory

National Provider Directory

Locations

31977 Lodge Rd
Auberry, CA 93602
Phone (209) 855-3601

31981 Lodge Rd
#102
Auberry, CA 93602
Phone (559) 855-3601

7407 N Cedar Ave
Ste 102
Fresno, CA 93720
Phone (559) 369-4421

1180 E Shaw Ave
Ste 125
Fresno, CA 93710
Phone (559) 228-4222

1133 R St
Fresno, CA 93721
Phone (559) 439-1119

6331 N Fresno St
Ste 104
Fresno, CA 93710
Phone (559) 437-2700

5424 N Palm Ave
#101
Fresno, CA 93704
Phone (559) 438-0800

7404N Cedar Ave 102
Fresno, CA 93720
Phone (599) 451-0893

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1821075748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28900",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93729",
            "telephone_number": "559-228-4200",
            "fax_number": "559-224-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 E SHAW AVE",
            "address_2": "STE 125",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107812",
            "telephone_number": "559-228-4200",
            "fax_number": "559-224-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL PROVIDERS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "NAKAMURA",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-228-5400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G50552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068691",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068696",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068690",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068695",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068692",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068693",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0068694",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.