California Medicaid lookup
One provider matched this Medicaid ID.
California Medicaid ID B2004201 resolves to a single NPI record. Open the full profile for complete detail.
✓
Single match found
When a Medicaid ID maps to more than one NPI, this page shows a chooser to pick the right provider instead.
JR
NPI · 1902958077 · Active
John Russell DDS
Dentist · Shasta Lake City, California
NPI
1902958077
Medicaid (CA)
B2004201
Taxonomy
122300000X
State
California
Secondary identifiers
Additional identifiers this provider has registered with NPPES. Used by medical billers, credentialers, and insurance verifiers to cross-reference claims and enrollments.
Medicaid
- B2004201CA
Source: NPPES public registry.
ReferenceAbout state Medicaid identifiers
State Medicaid programmes assign each enrolled provider a state-scoped identifier used on Medicaid claims. The identifier is reported to the federal NPPES registry alongside the provider's NPI and is mirrored here from the public dissemination file. Each state administers its own Medicaid programme, so the same provider can hold different Medicaid numbers in different states.