NPIMap

Organization Active NPI

County of Calaveras

Doing business as Calaveras Public Health Services

  • Public Health or Welfare Agency
  • San Andreas, CA
National Provider Identifier
1427168673
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COUNTY OF CALAVERAS
Doing business as
Calaveras Public Health Services
Practice address
700 Mountain Ranch Rd
C-2
San Andreas, CA 95249-9707
Phone
(209) 754-6460
Fax
(209) 754-6459
NPI assigned
Aug 30, 2006
Last updated
Jul 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
John H. Lawless
Title
Deputy Director of HHS
Phone
(209) 754-2816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

700 Mountain Ranch Rd
C-2
San Andreas, CA 95249-9707

Mailing address

891 Mountain Ranch Rd
San Andreas, CA 95249-9713
Phone (209) 754-6460

Other identifiers 1

IdentifierTypeStateIssuer
08481507MedicaidCA

Other names 1

  • Calaveras Public Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061106000159 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1052318045 Practice locations: San Andreas, CA

Other NPIs with the same Medicare PAC ID 1

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

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
05D0609784Calaveras County Health Department700 Mountain Ranch Road, Suite C-2, San Andreas, CA 95249Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
County of Calaveras8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

700 Mountain Ranch Rd
Ste C2
San Andreas, CA 95249
Phone (209) 754-6460

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1427168673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 MOUNTAIN RANCH RD",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499713",
            "telephone_number": "209-754-6460",
            "fax_number": "209-754-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNTAIN RANCH RD",
            "address_2": "C-2",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499707",
            "telephone_number": "209-754-6460",
            "fax_number": "209-754-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CALAVERAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "LAWLESS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR OF HHS",
        "authorized_official_telephone_number": "209-754-2816"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08481507",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calaveras Public Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Andreas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.