PROVIDENCE MEDICAL GROUP (NPI# 1194196832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194196832 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE MEDICAL GROUP |
| Practice Address |
1806 Wadsworth Avenue Bakersfield CA 93311 |
| Practice Telephone | 8057481687 |
| Mailing Telephone | 8057481687 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | MR. MATTHEW TATE (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 8057481687 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | PA19685 | CA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972533149 | Providence Medical Group | Obstetrics & Gynecology | 2912 Springboro Rd W, Suite 201, Dayton, OH 45439-1674 | 2006-07-04 |
| 1952947939 | Providence Medical Group | Orthopaedic Surgery | 8919 Parallel Pkwy Ste 555, Kansas City, KS 66112-3628 | 2019-11-25 |
| 1811304595 | Providence Medical Group | Podiatrist | 2912 Springboro Rd, Suite 201, Moraine, OH 45439-1674 | 2014-07-15 |
| 1760658371 | Providence Medical Group | Clinical Medical Laboratory | 2912 Springboro W, Suite 203, Moraine, OH 45439-1674 | 2008-05-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE MEDICAL GROUP | 105 W 8th Ave Ste 660e, Spokane, WA 99204-2302 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP | 1801 Lind Ave Sw, Renton, WA 98057 |
| Ohio Business Entities | PROVIDENCE MEDICAL GROUP - THE HEIGHTS | 2912 Springboro West, Suite 201, Dayton, OH 45439 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP ALASKA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Ohio Business Entities | PROVIDENCE MEDICAL GROUP LABORATORY | 2912 Springboro West, Dayton, OH 45439 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP MONTANA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL GROUP SOUTHWEST WASHINGTON | 1801 Lind Ave Sw, Renton, WA 98057 |
| Street Address |
1806 WADSWORTH AVENUE |
| City | BAKERSFIELD |
| State | CA |
| Zip Code | 93311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104469030 | Bk New Age. Inc. | Internal Medicine | 11703 Privet Pl, Bakersfield, CA 93311 | 2019-10-23 |
| 1245713197 | Brandon Mccullough | Dentist | 11120 Stockdale Hwy, #103, Bakersfield, CA 93311 | 2018-09-06 |
| 1871001602 | Centric Health | Internal Medicine | 4531 Buena Vista Rd, Bakersfield, CA 93311 | 2018-01-15 |
| 1518484971 | Alexandria Noelle Wilson | Specialist/Technologist | 9800 Green Oak Pl, Bakersfield, CA 93311 | 2017-08-26 |
| 1477093169 | Vishnu Patel | Pharmacist | 11500 Wakehurst Ct, Bakersfield, CA 93311 | 2017-03-01 |
| 1487102364 | Christina Lewis | Nurse Practitioner | 9900 Stockdale Hwy Ste 203, Bakersfield, CA 93311 | 2016-09-20 |
| 1629424866 | New Horizon Surgical Center, LLC | Clinic/Center | 4500 Trade Center Drive, Bakersfield, CA 93311 | 2016-05-06 |
| 1316300767 | Ellen Mccrary | Optometrist | 9000 Ming Ave Ste L1-b, Bakersfield, CA 93311 | 2016-04-02 |
| 1083076764 | Pratik Patel | Dentist | 8701 Camino Media Ste A, Bakersfield, CA 93311 | 2016-03-22 |
| 1841676434 | Rose Mwangi | Nurse Practitioner | 10001 Cobblestone Ave, Bakersfeild, CA 93311 | 2015-08-05 |
| Find all providers in zip 93311 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699282285 | Kern County Hospital Authority | General Acute Care Hospital | 6001 Truxtun Ave Ste 210, Bakersfield, CA 93309-0662 | 2018-01-04 |
| 1336668284 | Kern County Hospital Authority | General Acute Care Hospital | 2920 F St Ste B1, Bakersfield, CA 93301-1829 | 2017-09-12 |
| 1396286670 | Kern Medical | General Acute Care Hospital | 12716 Sable Point Drive, Bakersfield, CA 93312 | 2017-03-20 |
| 1376960005 | Kern County Hospital Authority | General Acute Care Hospital | 9330 Stockdale Hwy Ste 400, Bakersfield, CA 93311 | 2014-03-19 |
| 1659502029 | Kern Medical Center | General Acute Care Hospital | 2701 Bernard St Apt 55, Bakersfield, CA 93306-2936 | 2009-08-04 |
| 1063697233 | David M Fang | General Acute Care Hospital | 2531 Chester Ave, Bakersfield, CA 93301-2012 | 2008-01-07 |
| 1376623538 | Kern County Hospital Authority | General Acute Care Hospital | 1700 Mount Vernon Avenue, Bakersfield, CA 93306-4018 | 2006-10-16 |
| 1609856947 | Heart Hospital of Bk, LLC | General Acute Care Hospital | 3001 Sillect Avenue, Bakersfield, CA 93308 | 2006-01-20 |
| 1538157508 | San Joaquin Community Hospital | General Acute Care Hospital | 2615 Chester Ave, Bakersfield, CA 93301-2006 | 2005-10-12 |
| 1922578822 | Kern County Hospital Authority | General Acute Care Hospital | 3551 Q St, Bakersfield, CA 93301-1657 | 2018-12-04 |
| Find all providers in BAKERSFIELD | ||||
| City | BAKERSFIELD |
| Zip Code | 93311 |
Please comment or provide details below to improve the information on PROVIDENCE MEDICAL GROUP.
| 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.