Active NPI
Delta Radiology, Inc.
- Specialist
- Lodi, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- DELTA RADIOLOGY, INC.
- Practice address
- 975 S Fairmont Ave
Lodi, CA 95240-5118 - Phone
- (209) 334-3411
- NPI assigned
- Mar 15, 2007
- Last updated
- Sep 12, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Wolcott
- Title
- President
- Phone
- (209) 339-7560
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
975 S Fairmont Ave
Lodi, CA 95240-5118
Mailing address
PO Box 15498
Sacramento, CA 95851-0498
Phone (559) 455-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ47018Z | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, WI, PR, IL, MN, DE, PA, NJ, MD, KS, OK, MS, TX, CO, HI, GA, FL, NC, VA, OR, AZ, MA, NY, KY
Enrollment records 24
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Diagnostic Radiology Physician
- Stockton, CA
- NPI 1639499239
O20041013000834
-
- Diagnostic Radiology Physician
- Lodi, CA
- NPI 1043229271
O20041013000834
National Provider Directory
National Provider Directory- Tax ID family
- Delta Radiology Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Diagnostic Radiology Physician
- Lodi, CA
- NPI 1043229271
-
- Specialist
- Lodi, CA
- NPI 1740305846
-
- Specialist
- Stockton, CA
- NPI 1255413811
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba AH Medical Office Galt
- Rural Health Clinic/Center
- Galt, CA
- NPI 1164431383
Member Of
Locations
999 S Fairmont Ave
Ste 110
Lodi, CA 95240
Phone (209) 334-4416
1779 W Yosemite Ave
Ste 105
Manteca, CA 95337
Phone (209) 824-7444
1617 N California St
Ste 1B
Stockton, CA 95204
Phone (209) 948-6063
2320 N California St
Ste 3
Stockton, CA 95204
Phone (209) 466-5027
Practitioners & affiliated clinicians
Practitioners 134
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": "1173916800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1536710400000",
"number": "1881728327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 15498",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958510498",
"telephone_number": "559-455-4000",
"fax_number": "559-455-4007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 S FAIRMONT AVE",
"city": "LODI",
"state": "CA",
"postal_code": "952405118",
"telephone_number": "209-334-3411"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DELTA RADIOLOGY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-15",
"last_updated": "2018-09-12",
"status": "A",
"authorized_official_last_name": "WOLCOTT",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "209-339-7560"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ47018Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
- Delta Eye Medical Group, Inc.
- Delta Medical Group of Pathologists, Inc.
- Delta Radiology Medical Group, Inc.
- Delta Radiology, Inc.
- Delta Radiology, Inc.
- Delta Skilled Nursing Center, Inc. (Delta Rehabilitation & Care Center)
- Delu Chiropractic
- Kenneth Alexander Delu, D.C.
- Stanley Lawrence Demski III, DDS
- Josie Christine Denton
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.