HUMBOLDT RADIOLOGY MEDICAL GROUP INC (NPI# 1972655058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972655058 |
| Entity Type | Organization |
| Organization Name | HUMBOLDT RADIOLOGY MEDICAL GROUP INC |
| Practice Address |
2200 Harrison Ave Eureka CA 95501-3215 |
| Mailing Address |
Po Box 6428 Eureka CA 95502-6428 |
| Practice Telephone | 7074458121 |
| Mailing Telephone | 7074455431 |
| Mailing Fax Number | 7074453710 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-09-11 |
| Authorized Official Name | MRS. NANCY LOUISE COBINE (BILLING MANAGER) |
| Authorized Official Telephone | 7074455431 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | CN3976 | 01 | |
| CA | GR0015540 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073665055 | Humboldt Radiology Medical Group Inc | Radiology | 850 Highway 96, Willow Creek, CA 95573 | 2007-01-18 |
| 1942709803 | Humboldt Radiology Medical Group Inc | Radiology | 3300 Renner Dr, Fortuna, CA 95540-3120 | 2018-02-06 |
| 1538211719 | Humboldt Radiology Medical Group Inc | Radiology | 2675 Harris St, Eureka, CA 95503-4806 | 2007-01-17 |
| 1841342128 | Humboldt Radiology Medical Group Inc | Radiology | 733 Cedar St, Garberville, CA 95542-3201 | 2007-01-17 |
| 1326154196 | Humboldt Radiology Medical Group Inc | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-08-22 |
| Street Address |
2200 HARRISON AVE |
| City | EUREKA |
| State | CA |
| Zip Code | 95501-3215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558329920 | Thomas F Krenek Iv | Internal Medicine | 2200 Harrison Ave, Eureka, CA 95501-3215 | 2006-05-03 |
| 1841538162 | Humboldt Medical and Neurological Rehabilitation, Inc. | Physical Medicine & Rehabilitation | 2200 Harrison Ave, Eureka, CA 95501-3215 | 2013-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538795919 | Eric Meyer Goldsmith | Physical Therapist | 2306 Dean Street, Eureka, CA 95501 | 2020-03-18 |
| 1609406404 | Humboldt County Behavioral Health | Community/Behavioral Health | 638 W Clark St., Bldg. E, Eureka, CA 95501 | 2020-01-21 |
| 1740831767 | Jacqueline Renee Coghill | Nurse Practitioner | Waterfront Recovery Services, 2413 2nd St, Eureka, CA 95501 | 2019-09-20 |
| 1982177275 | Jenny Bugnacki | Case Manager/Care Coordinator | 721 Wood St, Eureka, CA 95501 | 2019-01-09 |
| 1073023107 | Humboldt Recovery Center Inc. | Substance Abuse Rehabilitation Facility | 1303 11th St, Eureka, CA 95501 | 2017-10-03 |
| 1730698283 | Gabriel Holtski | Naturopath | 1632 Broadway, Suite #252, Eureka, CA 95501 | 2017-09-27 |
| 1164951851 | Redwood Community Services, Inc. | Foster Care Agency | 2426 6th St, Eureka, CA 95501 | 2017-06-07 |
| 1033651922 | Narum Clinical Services | Social Worker | 930 3rd St, Suite 201, Eureka, CA 95501 | 2016-11-09 |
| 1750839510 | Sierra Marie Evers-hellmich | Physical Medicine & Rehabilitation | 2103 Myrtle Avenue, Eureka, CA 95501 | 2016-09-21 |
| 1558720623 | Jennifer Vu | Behavioral Analyst | 730 7th St Ste A, Eureka, CA 95501 | 2016-02-18 |
| Find all providers in zip 95501 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750654372 | Charles George Thierauf | Radiology | 463 Meramec View Drive, Eureka, MO 63025 | 2012-02-13 |
| 1194949727 | Ssm Berland Eureka Imaging Services LLC | Radiology | #20 The Legends Parkway Drive, Suite 160, Eureka, MO 63025 | 2007-04-13 |
| 1811946296 | Dean Gregory Holland | Radiology | 2330 Buhne St, Eureka, CA 95501-3237 | 2006-05-10 |
| 1194795849 | James Bryan Moore IIi | Radiology | 2700 Dolbeer Ave, Eureka, CA 95501 | 2006-01-25 |
| 1538211719 | Humboldt Radiology Medical Group Inc | Radiology | 2675 Harris St, Eureka, CA 95503-4806 | 2007-01-17 |
| 1285786350 | Humboldt Radiology Medical Group Inc. | Radiology | 2700 Dolbeer St, Eureka, CA 95501-4736 | 2007-01-17 |
| 1326154196 | Humboldt Radiology Medical Group Inc | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-08-22 |
| 1699784967 | Donald Craig Wheeler | Radiology | 550 Russ St, Eureka, CA 95501-4451 | 2006-08-05 |
| 1184673568 | Matthew Marc Fluke | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-05-10 |
| 1700835188 | Abraham Pera | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-05-10 |
| Find all providers in EUREKA | ||||
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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.