NPIMap

Organization Active NPI

Shingle Springs Rancheria

Doing business as Shingle Springs Health and Wellness Center

  • Health Service Clinic/Center
  • Placerville, CA
National Provider Identifier
1245356674
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
03000545 Issued in CA
Legal business name
SHINGLE SPRINGS RANCHERIA
Doing business as
Shingle Springs Health and Wellness Center
Practice address
5168 Honpie Rd
Placerville, CA 95667
Phone
(530) 387-4975
Fax
(530) 387-8006
NPI assigned
Mar 21, 2007
Last updated
May 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Regina Cuellar
Title
Tribal Chair
Phone
(530) 387-4970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 03000545 CA Primary

Addresses

Primary practice location

5168 Honpie Rd
Placerville, CA 95667

Mailing address

PO Box 1340
Shingle Springs, CA 95682
Phone (530) 387-4975

Other practice location 1

3106 Ponte Morino Dr Ste A
Cameron Park, CA 95682-8281
Phone (530) 387-8080

Other names 1

  • Shingle Springs Health and Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331000617 CA Part B Supplier - Clinic/Group Practice 6002863271 Receives reassigned benefits from 40 practitioners
Practice locations: Cameron Park, CA; Placerville, CA

National Provider Directory

National Provider Directory

Locations

3106 Ponte Morino Dr
Ste A
Cameron Park, CA 95682
Phone (530) 387-8080

4140 Mother Lode Dr
Ste 112
Shingle Springs, CA 95682
Phone (530) 672-8059

Practitioners & affiliated clinicians

Practitioners 55

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.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1245356674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "SHINGLE SPRINGS",
            "state": "CA",
            "postal_code": "95682",
            "telephone_number": "530-387-4975",
            "fax_number": "530-672-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5168 HONPIE RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-387-4975",
            "fax_number": "530-387-8006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3106 Ponte Morino Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "956828281",
            "country_code": "US",
            "telephone_number": "530-387-8080",
            "fax_number": "530-387-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHINGLE SPRINGS RANCHERIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "CUELLAR",
        "authorized_official_first_name": "REGINA",
        "authorized_official_title_or_position": "TRIBAL CHAIR",
        "authorized_official_telephone_number": "530-387-4970"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "03000545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shingle Springs Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.