NPIMap

Organization Active NPI

Sutter Lakeside Hospital

Doing business as Sutter Lakeside Hospital Mobile Health Clinic

  • Rural Health Clinic/Center
  • Lakeport, CA
National Provider Identifier
1073745337
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SUTTER LAKESIDE HOSPITAL
Doing business as
Sutter Lakeside Hospital Mobile Health Clinic
Practice address
5176 Hill Rd E
Lakeport, CA 95453-6300
Phone
(707) 262-5000
Fax
(707) 262-5005
NPI assigned
Aug 19, 2009
Last updated
Aug 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Authorized official

Name
Siri T. Nelson
Title
Chief Administrative Officer
Phone
(707) 262-5005

Specialties & licenses 1

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

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453-6300

Mailing address

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone (707) 262-5000

Other names 1

  • Sutter Lakeside Hospital Mobile Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sutter Lakeside Home Medical Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1250640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1073745337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-262-5000",
            "fax_number": "707-262-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300",
            "telephone_number": "707-262-5000",
            "fax_number": "707-262-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER LAKESIDE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-19",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "SIRI",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "707-262-5005"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Lakeside Hospital Mobile Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.