Mountain Family Health Care Center, a Medical Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

14893 Issued in CA

Legal business name

MOUNTAIN FAMILY HEALTH CARE CENTER, A MEDICAL CORPORATION

Practice address

5187 N 1St St Ste 105
Fresno, CA 93710-7896

Phone

(559) 226-6796

Fax

(559) 682-3061

NPI assigned

Sep 15, 2008

Organization subpart

No

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

Authorized official

Name

Neng Lee, NPNPI 1972511970

Title

President

Phone

(559) 226-6796

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mountain Family Health Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neng Lee, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fresno, CA
  • NPI 1972511970
  Medicare reassignment Care Compare group Authorized official
• Than Aye Aw, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Fresno, CA
  • NPI 1740295419

  Clinic/Center

  Medicare reassignment Care Compare group NPD
• Ifeatu Ekelem, M.D.

  • Pediatrics Physician
  • Clovis, CA
  • NPI 1932126844
  NPD (past)
• Joanne Kristen Rhoads, CFNP

  • Family Nurse Practitioner
  • Raymond, CA
  • NPI 1275511628
  NPD (past)

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1053560029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5187 N 1ST ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107896",
            "telephone_number": "559-226-6796",
            "fax_number": "559-682-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5187 N 1ST ST STE 105",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937107896",
            "telephone_number": "559-226-6796",
            "fax_number": "559-682-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN FAMILY HEALTH CARE CENTER, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2023-06-02",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "NENG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-226-6796",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "14893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C51340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Family Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Moultrie
• Lyndon Patrick Moultrie Jr.
• Rayana Mounlaphasith
• Molly Elizabeth Mounsey
• Robo Mounsithirath
• Mountain Valley Healthcare LLC
• Mountain View Home Care Services
• Michael Emeel Mousa, M.D.
• Jana Mowrer, MPH, RDN
• Alexandra Moy Torres, LMFT

• Family Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.