NPIMap

Organization Active NPI

Hill Country Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Round Mountain, CA
National Provider Identifier
1407914260
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
230000078 Issued in CA
Legal business name
HILL COUNTRY COMMUNITY CLINIC
Practice address
29632 Highway 299 East
Round Mountain, CA 96084-0228
Phone
(530) 337-5750
Fax
(530) 337-5754
NPI assigned
Dec 5, 2006
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Jo L CampbellNPI 1689336828
Title
Chief Executive Officer
Phone
(530) 945-3642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 230000078 CA Primary

Addresses

Primary practice location

29632 Highway 299 East
Round Mountain, CA 96084-0228

Mailing address

PO Box 228
Round Mountain, CA 96084-0228
Phone (530) 337-5750

Other identifiers 1

IdentifierTypeStateIssuer
FHC03894FMedicaidCA

Other names 1

  • Hill Country Health and Wellness Center Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100706000178 CA Part A Provider - Federally Qualified Health Center (FQHC) 1052442175 Practice locations: Round Mountain, CA
O20120425000422 CA Part B Supplier - Clinic/Group Practice 1052442175 Receives reassigned benefits from 37 practitioners
3 other NPIs on this enrollment
Practice locations: Redding, CA; Round Mountain, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407914260. Details of each certification follow.

Federally qualified health center certification: CCN 551842

Legal name
HILL COUNTRY COMMUNITY CLINIC
Doing business as
HILL COUNTRY HEALTH AND WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1997
Last certification
Oct 1, 1997
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 21, 1982 in CA
Enrollment address
29632 State Highway 299 E
Round Mountain, CA 96084

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 2

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3270 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3287

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Jo L Campbell Individual Corporate OfficerChief Executive Officer Apr 1, 2022
W-2 Managing EmployeeChief Executive Officer Apr 1, 2022 100%
Kalie Brisbon Individual Corporate DirectorBoard Member May 27, 2025
Lorraine Schlosser Individual Corporate DirectorBoard Member Sep 29, 2026
Margaret Ellen Sugg Individual Corporate DirectorBoard Vice Chair Mar 18, 2003
Larry Russell Individual Corporate DirectorBoard Member Oct 23, 2013
Doug Wakefield Individual Corporate DirectorBoard Chair Oct 28, 2015
Fred Newell Individual Corporate DirectorBoard Member Jul 27, 2005
Paula Percy Individual Corporate DirectorBoard Member May 27, 2017
David a Short Individual Corporate DirectorBoard Member Mar 1, 2026
Heather Wylie Individual Corporate DirectorTreasurer Jan 1, 2026
Elizabeth Messick Individual Corporate Director Oct 16, 2000
Lisa K Barry Individual Corporate Officer Apr 26, 2025

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hill Country Community ClinicRedding, CA, CCN 921081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 3, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 8

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

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1407914260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "ROUND MOUNTAIN",
            "state": "CA",
            "postal_code": "960840228",
            "telephone_number": "530-337-5750",
            "fax_number": "530-337-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29632 HIGHWAY 299 EAST",
            "city": "ROUND MOUNTAIN",
            "state": "CA",
            "postal_code": "960840228",
            "telephone_number": "530-337-5750",
            "fax_number": "530-337-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILL COUNTRY COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "530-945-3642"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "230000078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03894F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hill Country Health and Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Hill Country Health and Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Round Mountain, CA

Sources for this page

Verify at the official NPI Registry.