NPIMap

Organization Active NPI

Mountain Valleys Health Centers

Doing business as Burney Health Center

  • Federally Qualified Health Center (FQHC)
  • Burney, CA
National Provider Identifier
1245301308
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOUNTAIN VALLEYS HEALTH CENTERS
Doing business as
Burney Health Center
Practice address
37491 Enterprise Dr
Burney, CA 96013-4380
Phone
(530) 335-5457
Fax
(530) 335-3388
NPI assigned
Nov 12, 2006
Last updated
Jul 28, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNTAIN VALLEY HEALTH CENTERS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Brandon Watkins
Title
Cfo
Phone
(530) 999-9010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

37491 Enterprise Dr
Burney, CA 96013-4380

Mailing address

PO Box 277
Bieber, CA 96009-0277
Phone (530) 999-9010

Other names 1

  • Burney Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050429000424 CA Part B Supplier - Clinic/Group Practice 4284685538 Receives reassigned benefits from 52 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dorris, CA; Weed, CA; Tulelake, CA; Mount Shasta, CA; Fall River Mills, CA; Burney, CA; Bieber, CA
O20111213000657 CA Part A Provider - Federally Qualified Health Center (FQHC) 4284685538 Practice locations: Burney, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245301308. Details of each certification follow.

Federally qualified health center certification: CCN 051010

Legal name
MOUNTAIN VALLEYS HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 12, 2005
Last certification
May 12, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 16, 1981 in CA
Enrollment address
37491 Enterprise Dr
Burney, CA 96013-4379

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
Mountain Valleys Health Centers Inc

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Jana Blevins Individual Corporate DirectorBoard Member Nov 30, 2020
Edna Eades Individual Corporate DirectorBoard Member Jul 31, 2017
Shannon Gerig Individual Corporate OfficerCeo Aug 1, 2019
W-2 Managing EmployeeCeo Aug 1, 2019
Operational/Managerial ControlCeo Aug 1, 2019
John Hayes Individual Corporate DirectorBoard Member Oct 26, 2020
Susie Lorenzen Individual Corporate DirectorBoard Member Aug 31, 2020
Connie Voltura Individual Corporate DirectorBoard Member May 28, 2018
Lydia Hawkins Individual W-2 Managing EmployeeBilling Manager Mar 24, 2019
Becky Vaughan Individual Corporate DirectorBoard Member Feb 27, 2023
William James Billo Individual Corporate DirectorBoard Member Dec 1, 2016
Raul Figueroa Tamayo Individual Corporate DirectorBoard Member May 31, 2021
Edwin Stokes Individual Corporate DirectorBoard Member Nov 30, 2020
Bailey Hunt Individual W-2 Managing EmployeeBilling Manager Feb 10, 2025
Richard Fuentes Individual Corporate DirectorDirector Jan 5, 2011
Charlene Burgi Individual Corporate DirectorBoard Member May 28, 2018

Practitioners & affiliated clinicians

Practitioners 9

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": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1245301308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277",
            "city": "BIEBER",
            "state": "CA",
            "postal_code": "960090277",
            "telephone_number": "530-999-9010",
            "fax_number": "530-294-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37491 ENTERPRISE DR",
            "city": "BURNEY",
            "state": "CA",
            "postal_code": "960134380",
            "telephone_number": "530-335-5457",
            "fax_number": "530-335-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VALLEYS HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAIN VALLEY HEALTH CENTERS INC.",
        "enumeration_date": "2006-11-12",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-999-9010"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burney Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Burney Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burney, CA

Sources for this page

Verify at the official NPI Registry.