NPIMap

Organization Active NPI

Lake Health District

Doing business as Alturas Health Clinic

  • Family Medicine Physician
  • Alturas, CA
National Provider Identifier
1285062489
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0000001616 Issued in CA
Legal business name
LAKE HEALTH DISTRICT
Doing business as
Alturas Health Clinic
Practice address
535 S Main St
Alturas, CA 96101-4114
Phone
(530) 233-2288
Fax
(530) 223-1941
NPI assigned
Oct 24, 2013
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Charles Bodell Tveit
Title
Ceo
Phone
(541) 947-7307

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU
Family Medicine Physician 207Q00000X 0000001616 CA Primary

Addresses

Primary practice location

535 S Main St
Alturas, CA 96101-4114

Mailing address

700 South J St
Lakeview, OR 97630-1623
Phone (541) 947-2114

Other names 1

  • Alturas Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285062489. Details of each certification follow.

Rural health clinic certification: CCN 058701

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ALTURAS HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 1, 2017
Last certification
Jul 2, 2015
Ownership / control type
1B
Facility address
535 S Main St
Alturas, CA 96101
Related CCNs
381309

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/794039a8-89a5-42e7-a8af-b2a702849aea/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/91732642-b694-4776-bbd7-c7859cc968c4/

Practitioners & affiliated clinicians

Practitioners 3

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": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1285062489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SOUTH J ST",
            "city": "LAKEVIEW",
            "state": "OR",
            "postal_code": "976301623",
            "telephone_number": "541-947-2114",
            "fax_number": "541-947-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S MAIN ST",
            "city": "ALTURAS",
            "state": "CA",
            "postal_code": "961014114",
            "telephone_number": "530-233-2288",
            "fax_number": "530-223-1941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "TVEIT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BODELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-947-7307"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "0000001616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alturas Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alturas, CA

Sources for this page

Verify at the official NPI Registry.