NPIMap

Organization Active NPI

Mark Twain Medical Center

  • Rural Health Clinic/Center
  • San Andreas, CA
National Provider Identifier
1255730545
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
LCSW61487 Issued in CA
Legal business name
MARK TWAIN MEDICAL CENTER
Practice address
768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone
(209) 754-3521
Fax
(209) 754-2652
NPI assigned
Aug 22, 2014
Last updated
Aug 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Authorized official

Name
Mr. Jacob Lewis
Title
Cfo
Phone
(209) 754-3521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X LCSW61487 CA Primary

Addresses

Primary practice location

768 Mountain Ranch Rd
San Andreas, CA 95249-9707

Mailing address

768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone (209) 754-3521

National Provider Directory

National Provider Directory
Tax ID family
Mark Twain St Joseph Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408665600000",
    "number": "1255730545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499707",
            "telephone_number": "209-754-3521",
            "fax_number": "209-754-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499707",
            "telephone_number": "209-754-3521",
            "fax_number": "209-754-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TWAIN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "209-754-3521",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "LCSW61487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Andreas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.