Organization Active NPI

Genesis Center for Womens Health Inc

  • Obstetrics & Gynecology Physician
  • Roseville, CA
National Provider Identifier
1851993224
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GENESIS CENTER FOR WOMENS HEALTH INC
Practice address
151 N Sunrise Ave Ste 1411
Roseville, CA 95661-2934
Phone
(279) 888-6900
Fax
(279) 888-6901
NPI assigned
Nov 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Lystra Bonnie Wilson-Celestine, MD, MPHNPI 1003034018
Title
Member
Phone
(279) 888-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

151 N Sunrise Ave Ste 1411
Roseville, CA 95661-2934

Mailing address

151 N Sunrise Ave Ste 1411
Roseville, CA 95661-2934
Phone (279) 888-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211104001594 CA Part B Supplier - Clinic/Group Practice 5991193377 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22877/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1851993224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE STE 1411",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612934",
            "telephone_number": "279-888-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SUNRISE AVE STE 1411",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612934",
            "telephone_number": "279-888-6900",
            "fax_number": "279-888-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS CENTER FOR WOMENS HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "WILSON-CELESTINE",
        "authorized_official_first_name": "LYSTRA",
        "authorized_official_middle_name": "BONNIE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "279-888-6900",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.