NPIMap

Organization Active NPI

Barton Healthcare System

  • Emergency Medicine Physician
  • South Lake Tahoe, CA
National Provider Identifier
1306931357
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BARTON HEALTHCARE SYSTEM
Practice address
3860 Saddle Rd
South Lake Tahoe, CA 96150-8673
Phone
(530) 543-5575
Fax
(530) 541-8427
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Authorized official

Name
Dr. Clinton D Purvance, MD
Title
Ceo
Phone
(530) 541-3420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X CA Primary

Addresses

Primary practice location

3860 Saddle Rd
South Lake Tahoe, CA 96150-8673

Mailing address

2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5659

Other practice location 1

1501-A Kirkwood Meadows Dr
Kirkwood, CA 95646
Phone (209) 258-7236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040915000806 CA Part B Supplier - Clinic/Group Practice 1850293960 Receives reassigned benefits from 118 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: South Lake Tahoe, CA; Twin Bridges, CA; Kirkwood, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Barton Healthcare Syste13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3860 Saddle Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5575

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1306931357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 SADDLE RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961508673",
            "telephone_number": "530-543-5575",
            "fax_number": "530-541-8427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501-A Kirkwood Meadows Dr",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "CA",
            "postal_code": "95646",
            "country_code": "US",
            "telephone_number": "209-258-7236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BARTON HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "PURVANCE",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-541-3420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.