NPIMap

Organization Active NPI

McCloud Healthcare Clinic, Inc.

  • Bone Densitometry Radiologic Technologist
  • Mount Shasta, CA
National Provider Identifier
1003372624
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Bone Densitometry Radiologic TechnologistTaxonomy code 2471B0102X
Legal business name
MCCLOUD HEALTHCARE CLINIC, INC.
Practice address
828 Pine St
Mount Shasta, CA 96067-2137
Phone
(530) 926-4528
NPI assigned
Feb 19, 2019
Organization subpart
Yes
Parent organization
MCCLOUD HEALTHCARE CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Proffitt
Title
Ceo
Phone
(530) 964-2389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Bone Densitometry Radiologic TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 2471B0102X Primary

Addresses

Primary practice location

828 Pine St
Mount Shasta, CA 96067-2137

Mailing address

PO Box 1143
McCloud, CA 96057-1143
Phone (530) 964-2389

Other names 1

  • Siskiyou Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Robert M Adams MD5 organizations share this tax ID, including this one
Part of
Robert M Adams MD

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25248/brand/1/csg/1/fhir/r4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1003372624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "MCCLOUD",
            "state": "CA",
            "postal_code": "960571143",
            "telephone_number": "530-964-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672137",
            "telephone_number": "530-926-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLOUD HEALTHCARE CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCCLOUD HEALTHCARE CLINIC, INC.",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-964-2389"
    },
    "taxonomies": [
        {
            "code": "2471B0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siskiyou Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.