NPIMap

Organization Active NPI

Roseville Urology, Inc.

  • Urology Physician
  • Roseville, CA
National Provider Identifier
1871822072
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G68651 Issued in CA
Legal business name
ROSEVILLE UROLOGY, INC.
Practice address
5 Medical Plaza Dr
Suite 250
Roseville, CA 95661-2865
Phone
(916) 782-2229
Fax
(916) 797-9414
NPI assigned
Dec 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Authorized official

Name
David Raymond Couillard, MD
Title
Ceo
Phone
(916) 768-3290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X G68651 CA Primary

Addresses

Primary practice location

5 Medical Plaza Dr
Suite 250
Roseville, CA 95661-2865

Mailing address

7936 Indian Springs Way
Orangevale, CA 95662
Phone (916) 768-3290

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1871822072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7936 INDIAN SPRINGS WAY",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "95662",
            "telephone_number": "916-768-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PLAZA DR",
            "address_2": "SUITE 250",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612865",
            "telephone_number": "916-782-2229",
            "fax_number": "916-797-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE UROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "COUILLARD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-768-3290",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G68651",
            "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 Dec 17, 2009; 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.