NPIMap

Organization Active NPI

Omni Women'S Health Medical Group, Inc

  • Clinical Medical Laboratory
  • Fresno, CA
National Provider Identifier
1891997813
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
LAB61460F Issued in CA
Legal business name
OMNI WOMEN'S HEALTH MEDICAL GROUP, INC
Practice address
3812 N 1St St
Fresno, CA 93726-4301
Phone
(559) 495-3120
Fax
(559) 495-3134
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Authorized official

Name
Mr. Harold Grooms, M.D.NPI 1205837192
Title
Director
Phone
(559) 495-3120

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
Clinical Medical Laboratory 291U00000X LAB61460F CA Primary

Addresses

Primary practice location

3812 N 1St St
Fresno, CA 93726-4301

Mailing address

3812 N 1St St
Fresno, CA 93726-4301
Phone (559) 495-3120

Other identifiers 1

IdentifierTypeStateIssuer
LAB61460FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331000848 CA Part B Supplier - Clinic/Group Practice 4082606009 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fresno, CA; Clovis, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0961460Omni Women'S Health Medical Group, Inc3812 N First St, Fresno, CA 93726ComplianceJul 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Omni Women'S Health5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3152 N Millbrook Ave
Ste B
Fresno, CA 93703
Phone (559) 244-0133

2029 E Divisadero St
Fresno, CA 93701
Phone (559) 265-4490

2416 W Shaw Ave
Ste 106
Fresno, CA 93711
Phone (559) 438-1777

7005 N Milburn Ave
Ste 101
Fresno, CA 93722
Phone (559) 275-1400

7055 N Maple Ave
Ste 106
Fresno, CA 93720
Phone (559) 297-2259

1122 S St
Ste 102
Fresno, CA 93721
Phone (559) 268-1737

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1891997813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264301",
            "telephone_number": "559-495-3120",
            "fax_number": "559-495-3134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 N 1ST ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937264301",
            "telephone_number": "559-495-3120",
            "fax_number": "559-495-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI WOMEN'S HEALTH MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "GROOMS",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "559-495-3120",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "LAB61460F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB61460F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.