MENDOCINO MEDICAL ASSOCIATES, INC (NPI# 1598718165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598718165 |
| Entity Type | Organization |
| Organization Name | MENDOCINO MEDICAL ASSOCIATES, INC |
| Practice Address |
721 River Dr Suite A Fort Bragg CA 95437-5402 |
| Practice Telephone | 7079647241 |
| Practice Fax Number | 7079611192 |
| Mailing Telephone | 7079647241 |
| Mailing Fax Number | 7079611192 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BENJAMIN GRAHAM (PRESIDENT) |
| Authorized Official Telephone | 7079647241 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207Q00000X | Family Medicine | G35252 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM53828F | 05 | |
| CA | GR0060500 | 05 |
| Street Address |
721 RIVER DR SUITE A |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689671570 | Northern California Medical Assoc Inc | Internal Medicine | 721 River Dr, Ste A, Fort Bragg, CA 95437-5402 | 2005-07-07 |
| 1144561770 | Adventist Health Physicians Network | Clinic/Center | 721 River Dr, Suite C, Fort Bragg, CA 95437 | 2013-03-06 |
| 1902017932 | Theophil Jantz, D.o., Inc | Surgery | 721 River Dr, Ste B, Fort Bragg, CA 95437 | 2007-05-24 |
| 1740377118 | Zoe D Berna | Family Medicine | 721 River Dr, Suite A, Fort Bragg, CA 95437-5403 | 2006-10-06 |
| 1235225376 | Jack Linn Bellah | Orthopaedic Surgery | 721 River Dr, Suite B, Fort Bragg, CA 95437 | 2006-10-05 |
| 1447343116 | John Ernest Cottle Jr. | Family Medicine | 721 River Dr, Suite A, Fort Bragg, CA 95437 | 2006-10-02 |
| 1225049257 | John Gallo | Family Medicine | 721 River Dr, Suite A, Fort Bragg, CA 95437 | 2006-08-11 |
| 1013959915 | Linda K James | Surgery | 721 River Dr, Suite B, Fort Bragg, CA 95437-5402 | 2006-06-12 |
| 1376598573 | Keith F. Korver, M.d., Inc. | Surgery | 721 River Dr, Ste A, Fort Bragg, CA 95437-5402 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750511176 | Jeannie Schumpert Dias | Internal Medicine | 2817 Reilly St Stop A, Womack Army Medical Center, Mcxc Dom, Fort Bragg, NC 28310-7831 | 2009-07-20 |
| 1487665410 | Jason Kirkman | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2006-08-11 |
| 1497785695 | Kathleen Lucille Walsh | Internal Medicine | Clark Clinic, Fort Bragg, NC 28310-0001 | 2006-07-03 |
| 1982663563 | Jo Ellen Hirsch | Internal Medicine | Bldg M-4861 Logistics Ave, Joel Health Clinic, Fort Bragg, NC 28310-0001 | 2006-03-21 |
| 1184692113 | Young Sammy Choi | Internal Medicine | Department of The Army, Wamc Stop A, 2817 Reilly Road, Fort Bragg, NC 28310-7301 | 2006-03-08 |
| 1376535369 | Jennifer E Yates | Internal Medicine | Womack Internal Medicine, Reilly Road, Fort Bragg, NC 28310-0001 | 2005-08-17 |
| 1851754279 | Elizabeth Levine | Internal Medicine | 721 River Drive, Suite A, Fort Bragg, CA 95437-5403 | 2016-04-02 |
| 1154765345 | Karoline Johnson | Internal Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2013-04-18 |
| 1316266554 | Nathan Lewis Boyer | Internal Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2010-05-27 |
| 1821225129 | Aaron Richard Farmer | Internal Medicine | 2817 Reilly St, Womack Army Medical Center, Fort Bragg, NC 28310-7324 | 2009-06-15 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.