PEACH TREE HEALTHCARE (NPI# 1235157967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235157967 |
| Entity Type | Organization |
| Organization Name | PEACH TREE HEALTHCARE |
| Other Organization Name | MARYSVILLE IMMEDIATE CARE |
| Practice Address |
724 5th St Marysville CA 95901-5646 |
| Mailing Address |
1114 Yuba St Suite 144 Marysville CA 95901-4838 |
| Practice Telephone | 5307493242 |
| Practice Fax Number | 5307493248 |
| Mailing Telephone | 5307416245 |
| Mailing Fax Number | 5307419274 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2017-06-12 |
| Authorized Official Name | MR. GREG STONE (CEO) |
| Authorized Official Telephone | 5307416245 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEACH TREE HEALTHCARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA17722 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | NP21992 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207Q00000X | Family Medicine | C51623 | Allopathic & Osteopathic Physicians | |
| N | 208D00000X | General Practice | 2A012984 | CA | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | PA15585 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA16123 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207P00000X | Emergency Medicine | 132241 | CA | Allopathic & Osteopathic Physicians |
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
550000004 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC71068F | 05 |
| Other Name | Type Code |
|---|---|
| Marysville Immediate Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295213296 | Peach Tree Healthcare | Dentist | 1275 Tharp Rd., Yuba City, CA 95993 | 2018-08-01 |
| 1164886040 | Peach Tree Healthcare | Clinic/Center | 3810 Rosin Ct, Suite 100, Sacramento, CA 95834-1656 | 2016-04-07 |
| 1922598226 | Peach Tree Healthcare | Clinic/Center | 120 Independence Cir, Chico, CA 95973-4925 | 2018-05-14 |
| 1831689223 | Peach Tree Healthcare | Clinic/Center | 6585 Clark Rd Ste 360, Paradise, CA 95969-3500 | 2018-05-11 |
| 1841723327 | Peach Tree Healthcare | Clinic/Center | 1275 Tharp Rd, Yuba City, CA 95993-2645 | 2017-04-11 |
| 1679026884 | Peach Tree Healthcare | Pediatrics | 481 Plumas Blvd, Suite 101, Yuba City, CA 95991-5075 | 2016-07-25 |
| 1952761488 | Peach Tree Healthcare | Family Medicine | 3911 Norwood Ave, Sacramento, CA 95838-3361 | 2016-02-25 |
| 1346619582 | Peach Tree Healthcare | Clinic/Center | 1900 T St, Sacramento, CA 95811-6822 | 2015-09-17 |
| 1619361730 | Peach Tree Healthcare | Nurse Practitioner | 1900 T St, Sacramento, CA 95811-6822 | 2015-03-26 |
| 1184915092 | Peach Tree Healthcare | Social Worker | 1445 Veterans Memorial Cir, Ste B, Yuba City, CA 95993-3011 | 2011-04-26 |
| Street Address |
724 5TH ST |
| City | MARYSVILLE |
| State | CA |
| Zip Code | 95901-5646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982038121 | Sharon Lynn Ekedahl | Nurse Practitioner | 724 5th St, Marysville, CA 95901 | 2013-08-23 |
| 1326174194 | Cathleen Marie Crawford | Physician Assistant | 724 5th St, Marysville, CA 95901-5646 | 2007-02-26 |
| 1619030970 | Glenn Palmbaum | Family Medicine | 724 5th St, Marysville, CA 95901-5646 | 2006-12-18 |
| 1669578357 | Mark E Johnson | Emergency Medicine | 724 5th St, Marysville, CA 95901-5646 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407497837 | Jaskaranpreet Kaur Sahota | Emergency Medicine | 426 4th Street, Marysville, CA 95901 | 2019-10-07 |
| 1710486170 | County of Sutter | Community/Behavioral Health | 8 7th Street, Marysville, CA 95901 | 2018-02-12 |
| 1144747676 | Amanda Shaye Martinez | Counselor | 103 D St., Marysville, CA 95901 | 2017-08-25 |
| 1912424557 | Jasmine Nicole Powers-mesna | Behavior Technician | 413 Pine Street, Marysville, CA 95901 | 2017-08-24 |
| 1457874729 | Rena Raju | Counselor | 1496 N. Beale Rd, Marysville, CA 95901 | 2017-07-19 |
| 1700319027 | Daniel Joseph Desmond V | Specialist/Technologist | 12 E 18th St, Marysville, CA 95901 | 2017-04-04 |
| 1720510340 | Austin James Parr | Specialist/Technologist | 1919 B St, Marysville, CA 95901 | 2017-04-02 |
| 1720411549 | Ann Marie Vallier | Counselor | 320 H Street, Suite 2, Marysville, CA 95901 | 2013-08-15 |
| 1790968725 | Huntleigh Healthcare LLC | Durable Medical Equipment & Medical Supplies | 625 Dubois Street, Suite B, San Rafael, CA 95901 | 2007-12-13 |
| 1275742405 | Yuba County Children and Families At Risk Program | Community/Behavioral Health | 209 6th Street, Marysville, CA 95901 | 2007-05-22 |
| Find all providers in zip 95901 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | MARYSVILLE |
| Zip Code | 95901 |
Please comment or provide details below to improve the information on PEACH TREE HEALTHCARE.
| 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.