NPIMap

Organization Active NPI

Redwood Regional Medical Group

Doing business as Advanced Imaging

  • Body Imaging Physician
  • Sebastopol, CA
National Provider Identifier
1982791380
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
Legal business name
REDWOOD REGIONAL MEDICAL GROUP
Doing business as
Advanced Imaging
Practice address
652 Petaluma Ave
Suite I
Sebastopol, CA 95472-4256
Phone
(707) 829-2141
Fax
(707) 829-2966
NPI assigned
Oct 6, 2006
Last updated
Nov 15, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
REDWOOD REGIONAL MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Authorized official

Name
Helen Collins, M.D.NPI 1326060617
Title
President
Phone
(707) 546-4062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X NU Primary
Neuroradiology Physician 2085N0700X NU
Nuclear Radiology Physician 2085N0904X NU
Diagnostic Radiology Physician 2085R0202X NU

Addresses

Primary practice location

652 Petaluma Ave
Suite I
Sebastopol, CA 95472-4256

Mailing address

652 Petaluma Ave Ste I
Sebastopol, CA 95472-4266
Phone (707) 829-2141

Other identifiers 1

IdentifierTypeStateIssuer
GR0049209MedicaidCA

Other names 1

  • Advanced Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Redwood Regional Medica17 organizations share this tax ID, including this one
Part of
Redwood Regional Medica

Other organizations with this tax ID 16

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

View all 16

Locations

652 Petaluma Ave
Ste I
Sebastopol, CA 95472
Phone (707) 829-2141

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1982791380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE STE I",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724266",
            "telephone_number": "707-829-2141",
            "fax_number": "707-829-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE",
            "address_2": "SUITE I",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724256",
            "telephone_number": "707-829-2141",
            "fax_number": "707-829-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD REGIONAL MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REDWOOD REGIONAL MEDICAL GROUP",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-546-4062",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0049209",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.

Verify at the official NPI Registry.