Active NPI
Kimberly Rae Fairgrief
- Specialist
- Placerville, CA
National Provider Identifier
1891974465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4715
- Practice address
- 2914 Cold Springs Rd
Suite a
Placerville, CA 95667-4220 - Phone
- (530) 642-1715
- NPI assigned
- Oct 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4715 | CA | Primary |
Addresses
Primary practice location
2914 Cold Springs Rd
Suite a
Placerville, CA 95667-4220
Mailing address
2914 Cold Springs Rd
Suite a
Placerville, CA 95667-4220
Phone (530) 642-1715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4715 | Other | CA | CAS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1891974465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2914 COLD SPRINGS RD",
"address_2": "SUITE A",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956674220",
"telephone_number": "530-642-1715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2914 COLD SPRINGS RD",
"address_2": "SUITE A",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956674220",
"telephone_number": "530-642-1715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRGRIEF",
"first_name": "KIMBERLY",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-30",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "4715",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAS",
"identifier": "4715",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.