STONY GORGE MEDICAL SERVICES A MEDICAL CORPORATION (NPI# 1982060851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982060851 |
| Entity Type | Organization |
| Organization Name | STONY GORGE MEDICAL SERVICES A MEDICAL CORPORATION |
| Practice Address |
1133 W Sycamore St Willows CA 95988-2601 |
| Mailing Address |
13737 Noel Rd Ste 1600 Dallas TX 75240-1331 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 4694012386 |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-03-30 |
| Authorized Official Name | CHARLES MITCHELL (PRESIDENT) |
| Authorized Official Telephone | 4694012386 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1133 W SYCAMORE ST |
| City | WILLOWS |
| State | CA |
| Zip Code | 95988-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922085877 | Jacqueline Rachel Casey | Physician Assistant | 1133 W Sycamore St, Willows, CA 95988-2601 | 2005-12-30 |
| 1023622396 | Brett Dennis Brown | Physician Assistant | 1133 W Sycamore St, Willows, CA 95988-2601 | 2020-09-03 |
| 1366052219 | Chanele Dresser | Physical Therapy Assistant | 1133 W Sycamore St, Willows, CA 95988-2601 | 2020-08-05 |
| 1306481742 | Glenn Medical Center, LLC | General Acute Care Hospital | 1133 W Sycamore St, Willows, CA 95988-2601 | 2019-11-08 |
| 1144865577 | Glenn Medical Center, LLC | General Acute Care Hospital | 1133 W Sycamore St, Willows, CA 95988-2601 | 2019-11-08 |
| 1063054831 | Glenn Medical Center, LLC | Clinic/Center | 1133 W Sycamore St, Willows, CA 95988-2601 | 2019-10-14 |
| 1982169348 | Cheryl Ann Huffman | Physical Therapist | 1133 W Sycamore St, Willows, CA 95988-2601 | 2019-02-09 |
| 1477017382 | Glenn Medical Center, Inc | General Acute Care Hospital | 1133 W Sycamore St, Willows, CA 95988-2601 | 2019-01-24 |
| 1679045454 | Jason Mower | Physician Assistant | 1133 W Sycamore St, Willows, CA 95988-2601 | 2018-12-18 |
| 1306347547 | John Michael Christopher | Nurse Practitioner | 1133 W Sycamore St, Willows, CA 95988-2601 | 2018-02-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457415192 | Eric D Wunsch | Chiropractor | 414 N. Plumas Street, Willows, CA 95988 | 2006-12-20 |
| 1255438370 | Barbara Lynne Ackerman | Surgery | 130 Enright Ave, Willows, CA 95988 | 2006-09-20 |
| 1447282868 | Michell Danforth Knight | Physician Assistant | 460 W Sycamore St, Willows, CA 95988 | 2006-07-07 |
| 1770528457 | Marc Steven Bracy | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-18 |
| 1619949138 | John Richard Pierson | Dentist | 249 North Villa, Willows, CA 95988 | 2006-02-07 |
| 1619379922 | Gillian J Barbaria | Physical Therapist | 116 S Lassen St, Willows, CA 95988 | 2014-09-17 |
| 1558547828 | John Pierson Dds Inc | Dentist | 249 North Villa, Willows, CA 95988 | 2008-01-16 |
| 1891837449 | Zsolt H Kissevich | Dentist | 207 N Butte St, Willows, CA 95988 | 2007-02-12 |
| 1609812650 | Gary M Carson | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-20 |
| 1497791404 | Everett Patrick Shareck Jr. | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-20 |
| Find all providers in zip 95988 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770528457 | Marc Steven Bracy | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-18 |
| 1962512384 | Glenn Emergency Physicians Medical Group, Inc. | Emergency Medicine | 1133 W Sycamore St, Willows, CA 95988-2601 | 2006-08-30 |
| 1609812650 | Gary M Carson | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-20 |
| 1497791404 | Everett Patrick Shareck Jr. | Emergency Medicine | 1133 W Sycamore Street, Willows, CA 95988 | 2006-06-20 |
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|---|---|---|---|---|
| 1275134108 | Robert Rene Gosselin | Emergency Medicine | 14017 Banner Mtn Lookout Rd, Nevada City, CA 95959-9657 | 2020-11-06 |
| 1942811260 | Peter Mann Md Inc | Emergency Medicine | 7634 Girard Ave, La Jolla, CA 92037-4420 | 2020-08-11 |
| 1356959266 | Rgx Medical | Emergency Medicine | 1050 E Cypress Ave, Burbank, CA 91501-1310 | 2020-07-16 |
| 1942825112 | Blasko Medical Consultants Inc. | Emergency Medicine | 11576 Petunia Ct, Mira Loma, CA 91752-5013 | 2020-06-12 |
| 1316561517 | Sagen Consulting, PC | Emergency Medicine | 10053 Bret Ave, Cupertino, CA 95014-3518 | 2020-06-03 |
| 1265051304 | Madhok Medical Corporation | Emergency Medicine | 2309 Noriega St # 5, San Francisco, CA 94122-4239 | 2020-04-09 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1376177402 | Aria Urgent Care Associates, Inc | Emergency Medicine | 601 S Beach Blvd, Anaheim, CA 92804-3102 | 2020-02-27 |
| 1851922900 | Anna Lankester Webster | Emergency Medicine | 1600 Los Gamos Dr Ste 220, San Rafael, CA 94903-1842 | 2020-01-28 |
| 1487294385 | Cep America - Auc PC | Emergency Medicine | 240 La Casa Via Ste 200, Walnut Creek, CA 94598-4866 | 2020-01-09 |
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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.