Providence Family Practice Medical Group
NPI 1104979582 · Family Medicine Physician · Modesto, CA
Providence Family Practice Medical Group is a Family Medicine Physician organization in Modesto, CA (NPI 1104979582).
Provider details
- NPI number
- 1104979582
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kathie Cronin, Managing Partner(209) 491-2500
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-01-19
- Last updated
- 2020-08-22
Frequently asked questions
- What is Providence Family Practice Medical Group's NPI number?
- Providence Family Practice Medical Group's National Provider Identifier (NPI) is 1104979582, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Family Practice Medical Group?
- Providence Family Practice Medical Group is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Family Practice Medical Group located?
- Providence Family Practice Medical Group's practice location on file with NPPES is 1213 Coffee Rd, Modesto, CA 95355-4229.
- What is Providence Family Practice Medical Group's phone number?
- The practice phone number listed in the NPPES registry for Providence Family Practice Medical Group is (209) 491-2500.
- Who is the authorized official for Providence Family Practice Medical Group?
- The authorized official listed on Providence Family Practice Medical Group's NPPES record is Kathie Cronin, Managing Partner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Family Practice Medical Group's NPI active?
- Yes — Providence Family Practice Medical Group's NPI (1104979582) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.