NPIMap

Organization Active NPI

County of Tehama

Doing business as Tehama County Health Services Clinic

  • Rural Health Clinic/Center
  • Red Bluff, CA
National Provider Identifier
1043427388
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COUNTY OF TEHAMA
Doing business as
Tehama County Health Services Clinic
Practice address
1850 Walnut St
Red Bluff, CA 96080-3611
Phone
(530) 527-8491
Fax
(530) 527-0240
NPI assigned
May 17, 2007
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF TEHAMAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Ms. Jayme S Bottke
Title
Executive Director
Phone
(530) 527-8491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1850 Walnut St
Red Bluff, CA 96080-3611

Mailing address

PO Box 400
Red Bluff, CA 96080-0400
Phone (530) 527-8491

Other identifiers 6

IdentifierTypeStateIssuer
BCP13980FMedicaidCA
GR0087850MedicaidCA
RHM13980FMedicaidCA
HAP13980FMedicaidCA
LAB44254FMedicaidCA
C16305OtherRAILROAD MEDICARE

Other names 1

  • Tehama County Health Services Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050408001105 CA Part B Supplier - Clinic/Group Practice 2668433269 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Red Bluff, CA
O20170724002910 CA Part A Provider - Rural Health Clinic 2668433269 Practice locations: Red Bluff, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043427388. Details of each certification follow.

Rural health clinic certification: CCN 058910

Legal name
COUNTY OF TEHAMA
Doing business as
TEHAMA COUNTY HELATH SERVICES AGENCY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 1, 2006
Last certification
Jun 3, 2016
Ownership / control type
2A
Organization structure
GovernmentNon-profit
Enrollment address
1850 Walnut St
Red Bluff, CA 96080-3611

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Stanislaus Medical Cent113 organizations share this tax ID, including this one
Part of
Tehama County HC Lab

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • County of Tehama
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Red Bluff, CA
    • NPI 1467668616

    Member Of

    NPD member

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Deanna Gee Individual Corporate DirectorAssistant Executive Director Adm Oct 18, 2012
Operational/Managerial Control Oct 18, 2012

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1043427388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960800400",
            "telephone_number": "530-527-8491",
            "fax_number": "530-427-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 WALNUT ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803611",
            "telephone_number": "530-527-8491",
            "fax_number": "530-527-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF TEHAMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF TEHAMA",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "BOTTKE",
        "authorized_official_first_name": "JAYME",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-527-8491",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP13980F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0087850",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM13980F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HAP13980F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB44254F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C16305",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tehama County Health Services Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Bluff, CA

Sources for this page

Verify at the official NPI Registry.