Active NPI
Gregg D Nulton, M.D.
- Family Medicine Physician
- Elk Grove, CA
National Provider Identifier
1992800049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G59350
- Practice address
- 8170 Laguna Blvd
#220
Elk Grove, CA 95758-7901 - Phone
- (916) 691-5900
- Fax
- (916) 691-6736
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G59350 | CA | Primary |
Addresses
Primary practice location
8170 Laguna Blvd
#220
Elk Grove, CA 95758-7901
Mailing address
10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (855) 771-0335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G593500 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436486400000",
"number": "1992800049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 OLD PLACERVILLE RD",
"address_2": "SUITE 100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958272539",
"telephone_number": "855-771-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8170 LAGUNA BLVD",
"address_2": "#220",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957587901",
"telephone_number": "916-691-5900",
"fax_number": "916-691-6736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NULTON",
"first_name": "GREGG",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2015-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G59350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G593500",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.