ST. JUDE RADIOLOGY MEDICAL GROUP, INC. (NPI# 1043732019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043732019 |
| Entity Type | Organization |
| Organization Name | ST. JUDE RADIOLOGY MEDICAL GROUP, INC. |
| Practice Address |
4608 T St Sacramento CA 95819-4744 |
| Mailing Address |
Po Box 940 Newbury Park CA 91319-0940 |
| Practice Telephone | 7149923978 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | BRADLEY A. JACKSON (MEDICAL DIRECTOR / CEO) |
| Authorized Official Telephone | 7149923978 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790208155 | St. Jude Radiology Medical Group, Inc. | Radiology | 8070 Entrada De Luz E, San Diego, CA 92127-2561 | 2017-07-18 |
| 1043732001 | St. Jude Radiology Medical Group, Inc. | Radiology | 2059 Stratford Ave, South Pasadena, CA 91030-4640 | 2017-07-12 |
| 1750803722 | St. Jude Radiology Medical Group, Inc. | Radiology | 215 Tiburon Ct, Walnut Creek, CA 94597-3437 | 2017-07-12 |
| 1609398676 | St. Jude Radiology Medical Group, Inc. | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-07-12 |
| 1659893626 | St. Jude Radiology Medical Group, Inc. | Radiology | 7214 Wareham Dr, Tampa, FL 33647-1166 | 2017-07-12 |
| Street Address |
4608 T ST |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95819-4744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184153629 | Iv Radiology Medical Group | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2017-06-08 |
| 1912461013 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2019-01-23 |
| 1033683396 | Kennewick Radiology Group, PC | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2019-01-18 |
| 1982173050 | Radiological Associates Medical Group, Inc | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2018-11-19 |
| 1669940912 | Radiological Associates Medical Group, Inc | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2018-11-05 |
| 1720577745 | Century Radiology Medical Group, Inc | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2018-05-04 |
| 1417460080 | Los Robles Radiologic Associates | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2017-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808076 | Ashley Dumont | Naturopath | Zen Dermatology, 4801 J St, Sacramento, CA 95819 | 2020-10-12 |
| 1053893347 | Sacramento Foot and Ankle Center, Inc. | Podiatrist | 5030 J St Ste 300, Sacramento, CA 95819 | 2018-09-04 |
| 1558881557 | Herrfeldt Business Ventures Inc | In Home Supportive Care | 5363 H Street, Suite A, Sacramento, CA 95819 | 2017-06-21 |
| 1205288222 | Jerad Eugene Morris | Registered Nurse | 3939 J Street, Suite 310, Sacramento Anesthesia Medical Group, Sacramento, CA 95819 | 2016-07-02 |
| 1114306289 | Sacramento Skilled Nursing and Long Term Care Medical Group Inc. | Internal Medicine | 1133 42 Nd Street, Sacramento, CA 95819 | 2015-05-22 |
| 1366708901 | Beverly Lynne Meier-hanaway | Nurse Practitioner | 5151 F Street, Sutter Memorial Hospital, Sacramento, CA 95819 | 2012-04-09 |
| 1225319015 | Kaitlin J Nicoletti | Anesthesiology | 3939 J Street Suite 310, Sacramento, CA 95819 | 2011-09-07 |
| 1255654570 | Jamal Rahman Rahimi | Emergency Medicine | 4870 T St., Sacramento, CA 95819 | 2010-03-02 |
| 1265605273 | Earl Willis Weyers | Anesthesiology | 3939 J St Ste 310, Sacramento, CA 95819 | 2008-04-10 |
| 1376744599 | Jennifer E Keller | Surgery | 5725 F Street, Suite 3, Sacramento, CA 95819 | 2007-05-29 |
| Find all providers in zip 95819 | ||||
| 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 |
|---|---|---|---|---|
| 1598246209 | Solano Diagnostics Partners, A Calif Limited Partnership | Radiology | 3111 S St Apt 307, Sacramento, CA 95816-7065 | 2018-08-22 |
| 1992210850 | Jessica Deyanira Izquierdo | Radiology | 8233 Scottsdale Dr, Sacramento, CA 95828-4530 | 2017-12-13 |
| 1184153629 | Iv Radiology Medical Group | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2017-06-08 |
| 1396086443 | Vincent L Quilici | Radiology | 3601 Meadow Ln, Sacramento, CA 95864-1522 | 2013-03-13 |
| 1740416544 | Himaja Peddi | Radiology | 2800 L Street, Suite 610, Sutter Medical Foundation, Sacramento, CA 95816-5616 | 2009-06-08 |
| 1679735666 | Kathleen Khong | Radiology | 4860 Y St # 3100, Sacramento, CA 95817-2307 | 2008-06-30 |
| 1548443807 | Alexander M Kane | Radiology | 509 21st St, Sacramento, CA 95811-1118 | 2007-12-10 |
| 1245420447 | Jeffrey Steven Fountain | Radiology | 816 D St, Apt 13, Sacramento, CA 95814-0719 | 2007-07-25 |
| 1487856704 | Kamran Ahmed | Radiology | 2800 L Street Suite 610, Sacramento, CA 95816 | 2007-06-01 |
| 1548485733 | Tien Hong Tran | Radiology | 2800 L St Ste 610, Sacramento, CA 95816-5616 | 2007-04-14 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95819 |
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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.