NPIMap

Organization Active NPI

Dignity Health

  • Skilled Nursing Facility
  • Mount Shasta, CA
National Provider Identifier
1376535344
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
230000015 Issued in CA
Legal business name
DIGNITY HEALTH
Practice address
914 Pine St
Mount Shasta, CA 96067-2143
Phone
(530) 926-6111
Fax
(530) 926-9373
NPI assigned
Aug 16, 2005
Organization subpart
Yes
Parent organization
DIGNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Joe D'Angina
Title
Chief Financial Officer
Phone
(530) 225-6121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 230000015 CA Primary

Addresses

Primary practice location

914 Pine St
Mount Shasta, CA 96067-2143

Mailing address

914 Pine St
Mount Shasta, CA 96067-2143
Phone (530) 926-6111

Other identifiers 3

IdentifierTypeStateIssuer
721561129960670000OtherCAWPS-TRICARE
LTC55282HMedicaidCA
721561129OtherCAIRS

Other names 1

  • Mercy Medical Center Mt Shasta DP SNF Doing business as

National Provider Directory

National Provider Directory
Part of
Catholic Healthcare West

Locations

1700 Esplanade
Chico, CA 95926
Phone (530) 691-5920

4309 Stagecoach Rd
Dunsmuir, CA 96025
Phone (530) 235-2205

1625 Creekside Dr
Ste 101
Folsom, CA 95630
Phone (916) 984-1866

841 Sterling Pkwy
Ste 120
Lincoln, CA 95648
Phone (916) 645-3388

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

Practitioners & affiliated clinicians

Practitioners 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1376535344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-6111",
            "fax_number": "530-926-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-6111",
            "fax_number": "530-926-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "D'ANGINA",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "530-225-6121"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "230000015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS-TRICARE",
            "identifier": "721561129960670000",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55282H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "721561129",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical Center Mt Shasta DP SNF",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Medical Center Mt Shasta DP SNF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Shasta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.