Active NPI
Sudershan Kaur
- Community Health Registered Nurse
- Sacramento, CA
National Provider Identifier
1972618064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- 624796
- Practice address
- 4600 Broadway
Suite 1100 Primary Care Clinic
Sacramento, CA 95820 - Phone
- (916) 874-9670
- Fax
- (916) 874-9297
- NPI assigned
- Aug 20, 2006
- 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 |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 624796 | CA | Primary |
Addresses
Primary practice location
4600 Broadway
Suite 1100 Primary Care Clinic
Sacramento, CA 95820
Mailing address
4600 Broadway Suite 1100
Sacramento, CA 95820
Phone (916) 874-9670
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 624796 | CA | MD | Community Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Sacramento | Past | Accepting new patients |
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.
-
- Federally Qualified Health Center (FQHC)
- Sacramento, CA
- NPI 1366513061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972618064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 BROADWAY SUITE 1100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95820",
"telephone_number": "916-874-9670",
"fax_number": "916-874-9297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 BROADWAY",
"address_2": "SUITE 1100 PRIMARY CARE CLINIC",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95820",
"telephone_number": "916-874-9670",
"fax_number": "916-874-9297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUR",
"first_name": "SUDERSHAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "CA",
"license": "624796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.