NPIMap

Organization Active NPI

Alliance Medical Center

  • Federally Qualified Health Center (FQHC)
  • Healdsburg, CA
National Provider Identifier
1386841476
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
BCP03923F Issued in CA
Legal business name
ALLIANCE MEDICAL CENTER
Practice address
1381 University St
Healdsburg, CA 95448-3314
Phone
(707) 433-5494
Fax
(707) 385-2157
NPI assigned
Jul 2, 2007
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Joan Churchill
Title
Ceo
Phone
(707) 385-2306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X BCP03923F CA Primary

Addresses

Primary practice location

1381 University St
Healdsburg, CA 95448-3314

Mailing address

1381 University St
Healdsburg, CA 95448-3314
Phone (707) 433-5494

Other identifiers 1

IdentifierTypeStateIssuer
BCP03923FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Alliance Medical Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1386841476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 UNIVERSITY ST",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483314",
            "telephone_number": "707-433-5494",
            "fax_number": "707-385-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 UNIVERSITY ST",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483314",
            "telephone_number": "707-433-5494",
            "fax_number": "707-385-2157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "CHURCHILL",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-385-2306"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "BCP03923F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BCP03923F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Healdsburg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.