NPIMap

Organization Active NPI

Clarity-James Medical Services Corp

  • Psychiatry Physician
  • San Rafael, CA
National Provider Identifier
1972192953
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CLARITY-JAMES MEDICAL SERVICES CORP
Practice address
4040 Civic Center Dr Ste 200
San Rafael, CA 94903-4187
Phone
(111) 111-1111
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Authorized official

Name
Adam Wolf Widen
Title
Director
Phone
(415) 795-8050

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

4040 Civic Center Dr Ste 200
San Rafael, CA 94903-4187

Mailing address

4040 Civic Center Dr Ste 200
San Rafael, CA 94903-4187

Other identifiers 1

IdentifierTypeStateIssuer
C4674875OtherCABUSINESS LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210128002631 CA Part B Supplier - Clinic/Group Practice 2668886813 Receives reassigned benefits from 10 practitioners
Practice locations: San Rafael, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25478/brand/2/csg/1/fhir/r4

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1972192953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 CIVIC CENTER DR STE 200",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 CIVIC CENTER DR STE 200",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034187",
            "telephone_number": "111-111-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARITY-JAMES MEDICAL SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "WIDEN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "WOLF",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-795-8050"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "C4674875",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.

Verify at the official NPI Registry.