PARADISE MEDICAL GROUP, INC. (NPI# 1235111006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235111006 |
| Entity Type | Organization |
| Organization Name | PARADISE MEDICAL GROUP, INC. |
| Practice Address |
6470 Pentz Rd Suite A Paradise CA 95969-3674 |
| Practice Telephone | 5308726650 |
| Practice Fax Number | 5308726653 |
| Mailing Telephone | 5308726650 |
| Mailing Fax Number | 5308726653 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2012-01-11 |
| Authorized Official Name | RICHARD E. THORP (PRESIDENT/CEO) |
| Authorized Official Telephone | 5308726650 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ21920Z | 01 |
| Street Address |
6470 PENTZ RD SUITE A |
| City | PARADISE |
| State | CA |
| Zip Code | 95969-3674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215162540 | Jennifer Ann Curtis | Nurse Practitioner | 6470 Pentz Rd, Paradise, CA 95969-3674 | 2009-05-15 |
| 1003847450 | Richard B Turner | Family Medicine | 6470 Pentz Rd, Paradise, CA 95969-3674 | 2006-07-05 |
| 1477584001 | James Russell Logan | Pediatrics | 6470 Pentz Rd, Suite A, Paradise, CA 95969 | 2006-07-05 |
| 1588693261 | Kae T Aung | Internal Medicine | 6470 Pentz Rd, Suite B, Paradise, CA 95969-3674 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699234559 | Skala Chiropractic Inc | Chiropractor | 4413 Sierra Del Sol, Paradise, CA 95969 | 2019-03-19 |
| 1114463924 | Gary R Watts | Obstetrics & Gynecology | 5016 Lago Vista Way, Paradise, CA 95969 | 2017-01-18 |
| 1013367044 | Leslie Allison Bass | Registered Nurse | 1309 Nunneley Road, Paradise, CA 95969 | 2016-06-21 |
| 1457798977 | Lisa Marie Nelson | Counselor | 5910 Clark Road Suite 179, Paradise, CA 95969 | 2013-05-23 |
| 1700121597 | Ann Mary Sullivan | Marriage & Family Therapist | 955 Elliott Road, Paradise, CA 95969 | 2012-12-05 |
| 1255631693 | Paola Maria Mccarthy | Pharmacist | 6020 Clark Rd, Paradise, CA 95969 | 2010-11-02 |
| 1871821678 | Lisa Alison Franco | Occupational Therapist | 1633 Cypress Ln., Lifehouse/cypress, Paradise, CA 95969 | 2009-12-07 |
| 1700017548 | Michael C Reilly | Occupational Therapy Assistant | 1633 Cypress Lane, Paradise, CA 95969 | 2009-07-28 |
| 1992985899 | James D Salomone | Counselor | 7690 East Rd, Redwood Valley, CA 95969 | 2007-11-07 |
| 1548461619 | Paradise Ultrasound | Radiologic Technologist | 5921 Clark Rd, Ste. C, Paradise, CA 95969 | 2007-05-29 |
| Find all providers in zip 95969 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467959155 | Jason Vance Md A Medical Corporation | Family Medicine | 6480 Pentz Rd Ste B, Paradise, CA 95969-3672 | 2018-04-09 |
| 1699049064 | Harrison Gill | Family Medicine | 1849 Salida Way, Paradise, CA 95969-6032 | 2012-03-02 |
| 1194939660 | Suk Chun Lee | Family Medicine | 7321 Skyway, Paradise, CA 95969 | 2007-05-10 |
| 1386645539 | Dwight Larry Miller | Family Medicine | 6585 Clark Rd, Suite 440, Paradise, CA 95969-3500 | 2005-08-09 |
| 1952791907 | Galen Inpatient Physicians Inc | Family Medicine | 5974 Pentz Rd, Paradise, CA 95969-5509 | 2015-01-29 |
| 1841356342 | Randal Douglas Reed | Family Medicine | 5734 Canyon View Drive, Paradise, CA 95969-5503 | 2006-12-29 |
| 1477638807 | Jay Randal Sloop | Family Medicine | 5974 Pentz Rd, Paradise, CA 95969-5509 | 2006-10-26 |
| 1427069194 | Lynne Pappas | Family Medicine | 5125 Skyway, Paradise, CA 95969-5624 | 2006-08-10 |
| 1487677670 | Donald T Smith | Family Medicine | 5974 Pentz Rd, Paradise, CA 95969-5509 | 2006-07-26 |
| 1003847872 | Edgar H Clark | Family Medicine | 6585 Clark Rd, Suite 360, Paradise, CA 95969-3500 | 2006-07-06 |
| Find all providers in PARADISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.