NPIMap

Organization Active NPI

Greenville Rancheria

  • Cardiovascular Disease Physician
  • Redding, CA
National Provider Identifier
1013882877
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
GREENVILLE RANCHERIA
Practice address
2638 Edith Ave
Redding, CA 96001-3043
Phone
(530) 244-7192
Fax
(530) 244-4185
NPI assigned
Oct 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Antonia Louise Hayworth, CPC
Title
Billing Supervisor
Phone
(530) 528-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2638 Edith Ave
Redding, CA 96001-3043

Mailing address

2638 Edith Ave
Redding, CA 96001-3043
Phone (530) 244-7192

National Provider Directory

National Provider Directory
Tax ID family
Greenville Rancheria Tribal6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1013882877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 EDITH AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013043",
            "telephone_number": "530-244-7192",
            "fax_number": "530-244-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 EDITH AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960013043",
            "telephone_number": "530-244-7192",
            "fax_number": "530-244-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE RANCHERIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-09",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "HAYWORTH",
        "authorized_official_first_name": "ANTONIA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "530-528-8600",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.