NPIMap

Organization Active NPI

Impact Medical Group, Professional Corporation

  • Urgent Care Clinic/Center
  • Fresno, CA
National Provider Identifier
1891999108
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
IMPACT MEDICAL GROUP, PROFESSIONAL CORPORATION
Practice address
5261 E Kings Canyon Rd
Suite 107
Fresno, CA 93727-4028
Phone
(559) 452-1000
NPI assigned
Jun 12, 2007
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Ifeatu Ekelem, MD
Title
MD
Phone
(559) 452-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

5261 E Kings Canyon Rd
Suite 107
Fresno, CA 93727-4028

Mailing address

5261 E Kings Canyon Rd
Suite 107
Fresno, CA 93727-4028
Phone (559) 452-1000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1891999108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 E KINGS CANYON RD",
            "address_2": "SUITE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274028",
            "telephone_number": "559-452-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 E KINGS CANYON RD",
            "address_2": "SUITE 107",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937274028",
            "telephone_number": "559-452-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT MEDICAL GROUP, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "EKELEM",
        "authorized_official_first_name": "IFEATU",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "559-452-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 25, 2016; 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.