Individual provider Active NPI

Ian Webster Radloff, FNP-BC

  • Family Nurse Practitioner
  • Sacramento, CA
National Provider Identifier
1932940319
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95030003 Issued in CA
Practice address
2100 Capitol Ave
Sacramento, CA 95816-5721
Phone
(916) 442-4985
NPI assigned
Jun 1, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95030003 CA Primary

Addresses

Primary practice location

2100 Capitol Ave
Sacramento, CA 95816-5721

Mailing address

PO Box 191824
Sacramento, CA 95819-7824
Phone (916) 330-0346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250214001904 CA Practitioner - Nurse Practitioner 9537699939 Practice locations: Sacramento, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Health LLC CurrentSince Nov 4, 2024 Accepting new patients

Locations

900 E Main St
Ste 106
Grass Valley, CA 95945
Phone (530) 446-6164

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1932940319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191824",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958197824",
            "telephone_number": "916-330-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CAPITOL AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165721",
            "telephone_number": "916-442-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLOFF",
        "first_name": "IAN",
        "middle_name": "WEBSTER",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-01",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95030003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.