Active NPI
Jordan Jarvis, M.D.
- General Practice Physician
- Sacramento, CA
National Provider Identifier
1821173246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- G47577
- Practice address
- 4700 Northgate Blvd
Ste. 100
Sacramento, CA 95834-1128 - Phone
- (916) 929-6161
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G47577 | CA | Primary |
Addresses
Primary practice location
4700 Northgate Blvd
Ste. 100
Sacramento, CA 95834-1128
Mailing address
4700 Northgate Blvd
Ste. 100
Sacramento, CA 95834-1128
Phone (916) 929-6161
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47577 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821173246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 NORTHGATE BLVD",
"address_2": "STE. 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341128",
"telephone_number": "916-929-6161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 NORTHGATE BLVD",
"address_2": "STE. 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958341128",
"telephone_number": "916-929-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JARVIS",
"first_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G47577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.