Sacramento Pediatric Gastroenterology,Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A71235 Issued in CA

Legal business name

SACRAMENTO PEDIATRIC GASTROENTEROLOGY,INC.

Practice address

5767 Greenback LN
Suite 200
Sacramento, CA 95841-2013

Phone

(916) 332-1244

Fax

(916) 760-4147

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Yinka Kari Davies, MDNPI 1043321789

Title

Pediatric Gastroenterologist

Phone

(916) 332-1244

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Yinka K Davies, MD

  • Pediatric Gastroenterology Physician
  • Sacramento, CA
  • NPI 1043321789
  NPD (past) Authorized official

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361491200000",
    "number": "1982958351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 GREENBACK LN",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412013",
            "telephone_number": "916-332-1244",
            "fax_number": "916-760-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5767 GREENBACK LN",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412013",
            "telephone_number": "916-332-1244",
            "fax_number": "916-760-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRAMENTO PEDIATRIC GASTROENTEROLOGY,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2013-02-22",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "YINKA",
        "authorized_official_middle_name": "KARI",
        "authorized_official_title_or_position": "PEDIATRIC GASTROENTEROLOGIST",
        "authorized_official_telephone_number": "916-332-1244",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A71235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A721350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sacramento Optometric Group, a Professional Corporation
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• Sacramento Outpatient Recovery Services LLC
• Sacramento Pediatric Endocrine and Diabetes Medical Clinic Inc
• Sacramento Pediatrics Medical Group
• Sacramento Physician Group
• Sacramento Physicians Medical Group, Inc.
• Sacramento Plastic & Reconstructive Surgery Medical Group Inc
• Sacramento Psychiatric Associates

• Medical Specialty Clinic/Center in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; 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.