PARK AVENUE WALK IN CLINIC (NPI# 1942407283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942407283 |
| Entity Type | Organization |
| Organization Name | PARK AVENUE WALK IN CLINIC |
| Practice Address |
1280 Monument Blvd Ste 1 Concord CA 94520-4405 |
| Practice Telephone | 9258258181 |
| Practice Fax Number | 9258258383 |
| Mailing Telephone | 9258258181 |
| Mailing Fax Number | 9258258383 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2015-09-01 |
| Authorized Official Name | DR. KEVIN BUCKWALTER (PHYSICIAN OWNER) |
| Authorized Official Telephone | 9258258181 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | BUCKWALTER FAMILY MEDICINE LTD. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | A63401 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | NPI INDIVIDUAL | 1003813478 | 01 |
| CA | NPI TYPE 2 | 1942407283 | 01 |
| Street Address |
1280 MONUMENT BLVD STE 1 |
| City | CONCORD |
| State | CA |
| Zip Code | 94520-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275130163 | Jessica E. Hiers | Audiologist | 2280 Diamnond Blvd, Suite 520, Concord, CA 94520 | 2020-10-05 |
| 1538712690 | Melody Louise Todd | Student in an Organized Health Care Education/Training Program | 2112 Willow Pass Rd., Suite 500, Concord, CA 94520 | 2019-07-18 |
| 1497319446 | Nately Rose | Social Worker | Contra Costa County Behavioral Health, 2425 Bisso Lane, Ste 200, Concord, CA 94520 | 2019-04-25 |
| 1609331412 | Darien Mccollins Jr. | Case Manager/Care Coordinator | 2380 Salvio Street Stu 200, Concord, CA 94520 | 2019-02-06 |
| 1972072122 | Rocio Flores Neale | Physician Assistant | 2415 High School Avenue, Suite 800, Concord, CA 94520 | 2018-11-16 |
| 1386129138 | Vanessa Segovia | Registered Nurse | 2500 Bates Ave., Suite B, Concord, CA 94520 | 2018-09-27 |
| 1417442278 | Raquel Jihan Chiasson | Social Worker | 2900 Avon Avenue, Concord, CA 94520 | 2018-06-25 |
| 1184118143 | Angela Navarro | Behavioral Analyst | 1844 Overhill Rd, Concord, CA 94520 | 2018-06-21 |
| 1811498678 | Sherry Currie-proctor | Case Manager/Care Coordinator | 2380 Salvio Street, Concord, CA 94520 | 2018-02-26 |
| 1770082547 | Donna Christianson | Marriage & Family Therapist | 2401 Stanwell Drive, Suite 460, Office #2, Concord, CA 94520 | 2018-02-07 |
| Find all providers in zip 94520 | ||||
| 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 |
|---|---|---|---|---|
| 1730646282 | Gifted Guidance | Family Medicine | 960 Copperfield Blvd Ne, Concord, NC 28025-2433 | 2019-02-20 |
| 1831572353 | Mark Prodger | Family Medicine | 250 Pleasant Street Chfhc, Yeaple Building, Concord, NH 03301-7539 | 2015-07-01 |
| 1700209244 | Carolinas Physicians Network Inc | Family Medicine | 675 Memorial Blvd, Suite 100, Concord, NC 28025-2992 | 2014-02-03 |
| 1932441979 | Monica Therese Lawler | Family Medicine | 270 Copperfield Blvd Ne Ste 102, Concord, NC 28025-2443 | 2013-03-16 |
| 1174868368 | Doctors Plus Pllc | Family Medicine | 205 Branchview Drive, Concord, NC 28025 | 2012-11-29 |
| 1831357508 | Peter C Loeser | Family Medicine | 194 Pleasant St Ste 7, Concord, NH 03301-2952 | 2008-05-29 |
| 1548451149 | Tess Georgette Richards | Family Medicine | 270 Copperfield Blvd, Suite 102, Concord, NC 28025-2443 | 2007-08-08 |
| 1821289679 | Curtis Reinhold Preik | Family Medicine | 9915 Clarkes View Pl Nw, Concord, NC 28027-7235 | 2007-08-07 |
| 1285836783 | Suzanne Helen Powell | Family Medicine | 2000 Sierra Rd, Concord, CA 94518 | 2007-06-05 |
| 1114145075 | Eric Arciga Kropp | Family Medicine | 13 Chenell Dr, Suite 2, Concord, NH 03301-8539 | 2007-04-23 |
| Find all providers in CONCORD | ||||
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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.