NPIMap

Organization Active NPI

Barstow Primary Care Clinic

  • Internal Medicine Physician
  • Barstow, CA
National Provider Identifier
1871904656
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BARSTOW PRIMARY CARE CLINIC
Practice address
805 Mountain View
Barstow, CA 92311-3033
Phone
(760) 256-7161
NPI assigned
May 14, 2014
Last updated
Feb 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Revenue Cycl
Phone
(615) 221-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

805 Mountain View
Barstow, CA 92311-3033

Mailing address

805 Mountain View
Barstow, CA 92311-3033
Phone (760) 256-7161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140904001517 CA Part B Supplier - Clinic/Group Practice 7719105774 Receives reassigned benefits from 12 practitioners
Practice locations: Apple Valley, CA; Barstow, CA; Victorville, CA

National Provider Directory

National Provider Directory

Locations

16124 Kasota Rd
Ste A
Apple Valley, CA 92307
Phone (619) 242-2099

16124 Kasota Rd
Ste Ab
Apple Valley, CA 92307

16124 Kasota Rd
Ste C
Apple Valley, CA 92307
Phone (760) 780-0382

1890 W Main St
Barstow, CA 92311
Phone (760) 256-1422

500 S 7th Ave
Ste A
Barstow, CA 92311
Phone (760) 252-2168

500 S 7th Ave
Ste D
Barstow, CA 92311
Phone (760) 256-1777

803 E MTN VW St
Barstow, CA 92311

805 E Mountain View St
Barstow, CA 92311
Phone (760) 256-5026

15065 Vista Rd
Unit 7
Helendale, CA 92342
Phone (760) 243-2900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7705/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1871904656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MOUNTAIN VIEW",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113033",
            "telephone_number": "760-256-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 MOUNTAIN VIEW",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923113033",
            "telephone_number": "760-256-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARSTOW PRIMARY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-14",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REVENUE CYCL",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barstow, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.