Mark Twain St. Joseph'S Hospital

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

19190 Issued in CA

Legal business name

MARK TWAIN ST. JOSEPH'S HOSPITAL

Practice address

1919 Vista del Lago
Valley Springs, CA 95252

Phone

(209) 772-9538

NPI assigned

Dec 2, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Roy Shelden, MS

Title

Director of Medical Staff

Phone

(209) 754-3521

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1285936807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 MT RANCH RD.",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "95249",
            "telephone_number": "209-754-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 VISTA DEL LAGO",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "95252",
            "telephone_number": "209-772-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TWAIN ST. JOSEPH'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "SHELDEN",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "DIRECTOR OF MEDICAL STAFF",
        "authorized_official_telephone_number": "209-754-3521",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "19190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longs Drug Stores California LLC
• Josiah Lozano, PT,DPT
• M a C T Health Board Incorporated
• M a C T Health Board, Incorporated
• Mark Twain Health Care District
• Erin Lorraine McClain, MA, SLP-CF/RPE
• Melissa McConnell
• Margaret G. McInerney, D.M.D.
• Michael T Peters
• Denise Audrey Mordue-Lain, NP

• Health Service Clinic/Center in Valley Springs, CA
• Providers in Valley Springs, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.