NPIMap

Organization Active NPI

Shasta Regional Medical Group Inc

Doing business as Shasta Community Medical Group

  • Hospitalist Physician
  • Redding, CA
National Provider Identifier
1396990545
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SHASTA REGIONAL MEDICAL GROUP INC
Doing business as
Shasta Community Medical Group
Practice address
1355 East St Ste 200
Redding, CA 96001-0801
Phone
(530) 605-4263
NPI assigned
Dec 1, 2008
Last updated
Aug 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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

Authorized official

Name
Mrs. Venkamma Reddy, MDNPI 1124077698
Title
President
Phone
(530) 605-4263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Cardiovascular Disease Physician 207RC0000X
Vascular Surgery Physician 2086S0129X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

1355 East St Ste 200
Redding, CA 96001-0801

Mailing address

16850 Bear Valley Rd
Victorville, CA 92395-5794
Phone (760) 241-8000

Other names 1

  • SHASTA COMMUNITY MEDICAL GROUP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090310000251 CA Part B Supplier - Clinic/Group Practice 5991861353 Receives reassigned benefits from 66 practitioners
1 other NPI on this enrollment
Practice locations: Anderson, CA; Redding, CA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1801 W Olympic Blvd
#1640
Pasadena, CA 91199

1100 Butte St
Ste 200
Redding, CA 96001

1355 East St
Ste 210
Redding, CA 96001

1555 East St
Ste 120
Redding, CA 96001
Phone (530) 242-6122

1555 East St
Ste 200
Redding, CA 96001
Phone (530) 229-0911

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABEFCA

Practitioners & affiliated clinicians

Practitioners 69

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 69

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1396990545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 EAST ST STE 200",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010801",
            "telephone_number": "530-605-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA REGIONAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VENKAMMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-605-4263",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHASTA COMMUNITY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHASTA COMMUNITY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.