SIERRA NEVADA PRIMARY CARE (NPI# 1699719419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699719419 |
| Entity Type | Organization |
| Organization Name | SIERRA NEVADA PRIMARY CARE |
| Other Organization Name | SIERRA CARE PHYSICIANS |
| Practice Address |
140 Litton Dr Ste 110 Grass Valley CA 95945-5078 |
| Mailing Address |
Po Box 459001 Grass Valley CA 95945-9101 |
| Practice Telephone | 5302729770 |
| Practice Fax Number | 5302729796 |
| Mailing Telephone | 5302657833 |
| Mailing Fax Number | 5304701821 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-12-12 |
| Authorized Official Name | MR. DOUGLAS E WAGNER (PRESIDENT, BOARD OF DIRECTORS) |
| Authorized Official Telephone | 5302729791 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 20A7977 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | G55765 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | G13927 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G61414 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | A71856 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G23768 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G35403 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | A26753 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | G34453 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 20A79401 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sierra Care Physicians | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952621328 | Sierra Nevada Primary Care | Nurse Practitioner | 11400 Pleasant Valley Rd, Penn Valley, CA 95946-9001 | 2010-06-08 |
| 1548458839 | Sierra Nevada Primary Care | Pediatrics | 140 Litton Dr Ste 100, Grass Valley, CA 95945-5078 | 2007-10-11 |
| 1235145608 | Sierra Nevada Primary Care | Pediatrics | 140 Litton Dr Ste 100, Grass Valley, CA 95945-5078 | 2006-07-31 |
| Street Address |
140 LITTON DR STE 110 |
| City | GRASS VALLEY |
| State | CA |
| Zip Code | 95945-5078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801018775 | Judith Grace Gabler | Registered Nurse | 140 Litton Dr Ste 110, Grass Valley, CA 95945-5078 | 2007-05-02 |
| 1427148923 | Cheryl Elaine Cox | Physical Therapist | 140 Litton Dr Ste 110, Grass Valley, CA 95945-5078 | 2006-10-13 |
| 1508881459 | Constance E Gaulter | Family Medicine | 140 Litton Dr Ste 110, Grass Valley, CA 95945-5078 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568028595 | Rae Meyer Bastoni | Chiropractor | 124 Clydesdale Ct, Ste. K, Grass Valley, CA 95945 | 2019-05-15 |
| 1255815221 | Victoria M Goddard | Counselor | 900 East Main St Suite 201, Grass Valley, CA 95945 | 2018-09-17 |
| 1912488503 | Janell Dawn Jones | Pharmacist | 10106 East Dr, Grass Valley, CA 95945 | 2018-08-22 |
| 1184114779 | Evan Ariel Walters | Physical Therapist | 104 Magaret Lane, Grass Valley, CA 95945 | 2018-05-18 |
| 1295199420 | Allyssa Fennelly Skowyra | Chiropractor | 155 Spring Hill Dr Ste 201, Grass Valley, CA 95945 | 2016-04-13 |
| 1326417627 | Nevada County Crisis Stabilization Unit | Clinic/Center | 145 Glasson Way, Grass Valley, CA 95945 | 2015-09-17 |
| 1942607957 | California Mental Health | Counselor | 120 N. Auburn Street, Ste 212, Grass Valley, CA 95945 | 2014-11-20 |
| 1740611615 | Jarrett M Weiss | Residential Treatment Facility, Emotionally Disturbed Children | 714 W. Main Street, Grass Valley, CA 95945 | 2013-12-03 |
| 1669802732 | Nicole Marie Sullivan | Residential Treatment Facility, Emotionally Disturbed Children | 714 W Main Street, Grass Valley, CA 95945 | 2013-11-26 |
| 1316377369 | Michelene Arielle-nicole Stringer | Residential Treatment Facility, Emotionally Disturbed Children | 714 West Main Street, Grass Valley, CA 95945 | 2013-11-12 |
| Find all providers in zip 95945 | ||||
| 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 |
|---|---|---|---|---|
| 1427228253 | John Sivert Tendall | Family Medicine | 13473 Saffron Drive, Grass Valley, CA 95945 | 2008-03-07 |
| 1316132442 | Todd Bouchier | Family Medicine | 280 Sierra College Dr Ste 207, Grass Valley, CA 95945-5769 | 2007-09-11 |
| 1205057544 | David Lee Kessler | Family Medicine | 307 S. Auburn St., Grass Valley, CA 95945 | 2007-05-02 |
| 1891832242 | Byron Fisk Lake | Family Medicine | 300 Sierra College Dr Ste 170, Grass Valley, CA 95945-5083 | 2007-02-01 |
| 1750449138 | William Durbrow IIi | Family Medicine | 120 Bank Street, Grass Valley, CA 95945 | 2006-12-05 |
| 1558472159 | Kay E Drengler | Family Medicine | 10058 Wolf Rd, Grass Valley, CA 95949-8194 | 2006-08-31 |
| 1396769527 | Susan E Shapiro | Family Medicine | 13793 Christopher Robin Way, Grass Valley, CA 95945-9335 | 2006-07-27 |
| 1487689840 | John Calvin Jackson Iv | Family Medicine | 10565 Brunswick Rd, Ste 1, Grass Valley, CA 95945-9053 | 2006-07-12 |
| 1568420750 | Linda Kay Foshagen | Family Medicine | 225 Colfax Avenue, Grass Valley, CA 95945-6810 | 2006-05-04 |
| 1689640658 | Jill Elizabeth Fitzpatrick | Family Medicine | 280 Sierra College Dr, Suite 120, Grass Valley, CA 95945-5763 | 2006-02-28 |
| Find all providers in GRASS VALLEY | ||||
| City | GRASS VALLEY |
| Zip Code | 95945 |
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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.