Individual provider Active NPI

John R Bringhurst, M.D.

  • Family Medicine Physician
  • Woodland, CA
National Provider Identifier
1992724017
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G60854 Issued in CA
Practice address
632 W Gibson Road
Woodland, CA 95695-2900
Phone
(530) 666-1631
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G60854 CA Primary

Addresses

Primary practice location

632 W Gibson Road
Woodland, CA 95695-2900

Mailing address

632 W Gibson Road
Woodland, CA 95695-2900
Phone (530) 666-1631

Other identifiers 2

IdentifierTypeStateIssuer
080046302OtherCARR MEDICARE
080086122OtherCAMEDICARE RAILROAD CARRIER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081124000401 CA Practitioner - Family Practice 3577623321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60854CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1992724017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 W GIBSON ROAD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952900",
            "telephone_number": "530-666-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 W GIBSON ROAD",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952900",
            "telephone_number": "530-666-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINGHURST",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G60854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080046302",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "080086122",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.