NPIMap

Organization Active NPI

Stallant Medical Group Inc

  • Rural Health Clinic/Center
  • Crescent City, CA
National Provider Identifier
1366082463
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
STALLANT MEDICAL GROUP INC
Practice address
515 E Washington Blvd
Crescent City, CA 95531-8342
Phone
(707) 460-1802
NPI assigned
Jan 7, 2020
Last updated
May 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Authorized official

Name
Robert Steffens
Title
Coo
Phone
(707) 460-1802

Specialties & licenses 1

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

Addresses

Primary practice location

515 E Washington Blvd
Crescent City, CA 95531-8342

Mailing address

PO Box 518
Weimar, CA 95736-0518
Phone (707) 460-1802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200225002364 CA Part A Provider - Rural Health Clinic 6406283845 Practice locations: Crescent City, CA
O20251229000818 CA Part B Supplier - Clinic/Group Practice 6406283845 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
Practice locations: Highland, CA; Crescent City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366082463. Details of each certification follow.

Rural health clinic certification: CCN 558906

Legal name
STALLANT MEDICAL GROUP INC
Doing business as
STALLANT HEALTH AND WELLNESS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 18, 2020
Last certification
Sep 11, 2023
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Nov 7, 2019 in CA
Enrollment address
515 E Washington Blvd
Crescent City, CA 95531-8342

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2183490Stallant Medical Group Inc515 E. Washington Blvd., Crescent City, CA 95531Certificate of waiverDec 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Stallant Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

785 E Washington Blvd
Ste 8
Crescent City, CA 95531
Phone (707) 460-1802

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Randall Steffens II Individual Corporate OfficerChief Information Officer Nov 7, 2019
Robert Steffens Individual Corporate OfficerChief Operating Officer Dec 6, 2019
Joshua Nebblett Individual Corporate OfficerCfo Dec 6, 2019
Linda Steffens Individual Corporate OfficerChief Nursing Officer Dec 6, 2019
Richard Steffens Individual Corporate OfficerChief Experience Officer Nov 7, 2019
Randall L Steffens Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Nov 7, 2019 100%
Corporate OfficerCeo Nov 7, 2019 100%
Corporate DirectorChief Executive Officer Nov 7, 2019 100%
April Thompson Individual W-2 Managing EmployeeAd; Nov 12, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780012800000",
    "number": "1366082463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "WEIMAR",
            "state": "CA",
            "postal_code": "957360518",
            "telephone_number": "707-460-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E WASHINGTON BLVD",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318342",
            "telephone_number": "707-460-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STALLANT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A",
        "authorized_official_last_name": "STEFFENS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-460-1802"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

Verify at the official NPI Registry.