NPIMap

Organization Active NPI

Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Walnut Creek, CA
National Provider Identifier
1821488966
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GOLDEN STATE ORTHOPEDICS & SPINE
Practice address
2625 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone
(925) 939-8585
Fax
(925) 933-2709
NPI assigned
Jan 28, 2015
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GOLDEN STATE ORTHOPEDICS & SPINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Authorized official

Name
KC Campion
Title
Ceo
Phone
(925) 210-8573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

2625 Shadelands Dr
Walnut Creek, CA 94598-2512

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000721 CA Part B Supplier - Clinic/Group Practice 8224940739 Receives reassigned benefits from 275 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakland, CA; San Francisco, CA; San Jose, CA; San Ramon, CA; Santa Clara, CA; Walnut Creek, CA; Watsonville, CA; Mountain View, CA…
O20150722003633 CA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8224940739 Practice locations: Walnut Creek, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

National Provider Directory

National Provider Directory
Part of
Muir Orthopaedic Specia

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1800 Sutter St
Ste 100
Concord, CA 94520
Phone (925) 691-0500

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1821488966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 SHADELANDS DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945982512",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE ORTHOPEDICS & SPINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOLDEN STATE ORTHOPEDICS & SPINE",
        "enumeration_date": "2015-01-28",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "CAMPION",
        "authorized_official_first_name": "KC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-210-8573"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.