NPIMap

Organization Active NPI

Pine Mountain Nursing Health Center, Inc.

Doing business as Pine Mountain Health Center

  • Community Health Clinic/Center
  • Arcata, CA
National Provider Identifier
1285056994
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
C3624118 Issued in CA
Legal business name
PINE MOUNTAIN NURSING HEALTH CENTER, INC.
Doing business as
Pine Mountain Health Center
Practice address
770 10TH St
Arcata, CA 95521-6210
Phone
(707) 826-8633
NPI assigned
Jan 15, 2014
Last updated
Dec 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Authorized official

Name
Mrs. Sharon M Powell, FNP-CNPI 1790898039
Title
Owner
Phone
(661) 242-2592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X C3624118 CA Primary

Addresses

Primary practice location

770 10TH St
Arcata, CA 95521-6210

Mailing address

16233 Askin Dr.
Suite a
Frazier Park, CA 93222-6536
Phone (661) 242-2592

Other practice location 1

16233 Askin Dr.
Suite A
Frazier Park, CA 93222-6536
Phone (661) 242-2592

Other names 1

  • Pine Mountain Health Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1285056994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16233 ASKIN DR.",
            "address_2": "SUITE A",
            "city": "FRAZIER PARK",
            "state": "CA",
            "postal_code": "932226536",
            "telephone_number": "661-242-2592",
            "fax_number": "661-262-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 10TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216210",
            "telephone_number": "707-826-8633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16233 Askin Dr.",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Frazier Park",
            "state": "CA",
            "postal_code": "932226536",
            "country_code": "US",
            "telephone_number": "661-242-2592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PINE MOUNTAIN NURSING HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-242-2592",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "C3624118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Mountain Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.