NPIMap

Organization Active NPI

Downriver, PC

  • Electrodiagnostic Medicine Physician
  • Fair Oaks, CA
National Provider Identifier
1992292965
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electrodiagnostic Medicine PhysicianTaxonomy code 204R00000X
Legal business name
DOWNRIVER, PC
Practice address
3906 Edgevale CT
Fair Oaks, CA 95628-7612
Phone
(972) 412-5299
Fax
(469) 453-3374
NPI assigned
Apr 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Tyler G Smith, MDNPI 1386650802
Title
Sole MBR
Phone
(800) 310-7334

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204R00000X Primary

Addresses

Primary practice location

3906 Edgevale CT
Fair Oaks, CA 95628-7612

Mailing address

Dept. 880231 PO Box 29650
Phoenix, AZ 85038-9650
Phone (972) 412-5299

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1992292965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 880231 PO BOX 29650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389650",
            "telephone_number": "972-412-5299",
            "fax_number": "469-453-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 EDGEVALE CT",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287612",
            "telephone_number": "972-412-5299",
            "fax_number": "469-453-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNRIVER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-16",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "800-310-7334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Electrodiagnostic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.