MERCY MEDICAL GROUP (NPI# 1841438603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841438603 |
| Entity Type | Organization |
| Organization Name | MERCY MEDICAL GROUP |
| Other Organization Name | MERCY MEDIAL GROUP - FOLSOM, A SERVICE OF CHW |
| Practice Address |
1700 Prairie City Rd Folsom CA 95630-9594 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9163514800 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2012-10-23 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A61317 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Mercy Medial Group - Folsom, A service of CHW | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053352971 | Mercy Medical Group | Pediatrics | 2630 Union Lake Rd, Suite 100, Commerce Township, MI 48382-3582 | 2006-06-10 |
| 1073829636 | Mercy Medical Group | Non-Pharmacy Dispensing Site | 3427 Robin Ln, 100, Cameron Park, CA 95682-7254 | 2010-08-20 |
| 1457689143 | Mercy Medical Group | Nurse Practitioner | 3000 Q St, Sacramento, CA 95816-7058 | 2009-11-18 |
| 1912045774 | Mercy Medical Group | Nurse Practitioner | 1812 S Rochester Rd, Rochester Hills, MI 48307-3532 | 2007-02-02 |
| 1932219383 | Mercy Medical Group | Dentist | 44405 Woodward Ave, Pontiac, MI 48341-5023 | 2006-08-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Ohio Business Entities | MERCY MEDICAL GROUP | 1822 Cherry St, Toledo, OH 43608 |
| Massachusetts Corporations | MERCY MEDICAL GROUP, INC. | 271 Carew St., Springfield, MA 01104 |
| Street Address |
1700 PRAIRIE CITY RD |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-9594 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932185246 | Debra Ebersole Kauffman | Registered Nurse | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2005-12-19 |
| 1538613989 | Claire Ann Saul Nazareno | Nurse Practitioner | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2016-08-14 |
| 1265884191 | Austin Saavedra | Family Medicine | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2016-07-03 |
| 1912330648 | Megan Anzar Frost Babb | Family Medicine | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2013-08-16 |
| 1386080919 | Rochelle Moralde | Registered Nurse | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2013-05-22 |
| 1710237821 | Gagan Preet Garcha | Internal Medicine | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2012-09-17 |
| 1659667574 | Gurkaran Singh Garcha | Internal Medicine | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2011-06-20 |
| 1861785768 | Marvi Marie Llenado Montano-ip | Pediatrics | 1700 Prairie City Rd, Folsom, CA 95630 | 2011-05-25 |
| 1649414293 | Cecilia Romo Divin | Family Medicine | 1700 Prairie City Rd, Folsom, CA 95630-9594 | 2009-04-27 |
| 1649476011 | Dina Medeiros Dixon | Physician Assistant | 1700 Prairie City Rd, Folsom, CA 95630 | 2007-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
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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.