Stony Gorge Medical Services a Medical Corporation

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

STONY GORGE MEDICAL SERVICES A MEDICAL CORPORATION

Practice address

1133 W Sycamore St
Willows, CA 95988-2601

Phone

(469) 401-2386

NPI assigned

Jan 8, 2016

Last updated

Mar 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Mitchell, MD

Title

President

Phone

(469) 401-2386

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1982060851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 W SYCAMORE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882601",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY GORGE MEDICAL SERVICES A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-401-2386",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Marie Skeels
• Melissa Sloan, FNP
• Ryan Smith, PTA
• Linyu Edith Solis, BA
• Karen Jeannine St John, RN
• Sunbridge Healthcare LLC (Willows Care Center)
• Kaitlyn Swihart
• Esbeydi Scarlett Tapia Castrejon
• Dennis S. Thodas, DDS
• Billy Throm Jr., D.C.

• Emergency Medicine Physician in Willows, CA
• Providers in Willows, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.