NPIMap

Organization Active NPI

Barton Healthcare System

Doing business as Barton Family Medicine

  • Primary Care Clinic/Center
  • South Lake Tahoe, CA
National Provider Identifier
1154631703
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0300000676 Issued in CA
Legal business name
BARTON HEALTHCARE SYSTEM
Doing business as
Barton Family Medicine
Practice address
1090 3Rd St
Ste 1
South Lake Tahoe, CA 96150-3485
Phone
(530) 543-5660
Fax
(530) 542-1619
NPI assigned
Oct 18, 2010
Reactivated
Apr 19, 2017
Last updated
Apr 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Authorized official

Name
Richard Paul Derby
Title
Cfo
Phone
(530) 543-5841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0300000676 CA Primary

Addresses

Primary practice location

1090 3Rd St
Ste 1
South Lake Tahoe, CA 96150-3485

Mailing address

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659

Other names 1

  • Barton Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Barton Memorial Hospita13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

1090 3rd St
Ste 1
South Lake Tahoe, CA 96150
Phone (530) 542-1900

Practitioners & affiliated clinicians

Practitioners 5

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": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1154631703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 3RD ST",
            "address_2": "STE 1",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503485",
            "telephone_number": "530-543-5660",
            "fax_number": "530-542-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTON HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2017-04-19",
        "deactivation_date": "2015-05-22",
        "reactivation_date": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "DERBY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-543-5841"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "0300000676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barton Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.