NPIMap

Organization Active NPI

Jewish Community Free Clinic

  • Primary Care Clinic/Center
  • Rohnert Park, CA
National Provider Identifier
1972807949
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
550001029 Issued in CA
Legal business name
JEWISH COMMUNITY FREE CLINIC
Practice address
490 City Center Dr
Rohnert Park, CA 94928-2178
Phone
(707) 585-7780
Fax
(707) 585-7784
NPI assigned
Jan 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Authorized official

Name
Mr. James Connell, M.D.
Title
Medical Director
Phone
(707) 585-7780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 550001029 CA Primary

Addresses

Primary practice location

490 City Center Dr
Rohnert Park, CA 94928-2178

Mailing address

490 City Center Dr
Rohnert Park, CA 94928-2178
Phone (707) 585-7780

National Provider Directory

National Provider Directory
Tax ID family
Jewish Community Free Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1972807949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 CITY CENTER DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282178",
            "telephone_number": "707-585-7780",
            "fax_number": "707-585-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 CITY CENTER DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282178",
            "telephone_number": "707-585-7780",
            "fax_number": "707-585-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWISH COMMUNITY FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "707-585-7780",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "550001029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.