NPIMap

Organization Active NPI

Barton Healthcare System

  • Diagnostic Radiology Physician
  • Stateline, NV
National Provider Identifier
1467046102
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BARTON HEALTHCARE SYSTEM
Practice address
155 Highway 50
Stateline, NV 89449-9816
Phone
(530) 543-5850
NPI assigned
Feb 23, 2021
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BARTON HEALTHCARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Ashley Russell
Title
Credentialing Specialist
Phone
(530) 543-5636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

155 Highway 50
Stateline, NV 89449-9816

Mailing address

2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220830004119 NV Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1850293960 Practice locations: Stateline, NV

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Barton Memorial Hosp13 organizations share this tax ID, including this one
Part of
Barton Memorial Hosp

Other organizations with this tax ID 12

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

Member of 1

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

Locations

212 Elks Point Rd
Unit 201
Zephyr Cove, NV 89448
Phone (775) 588-9188

Ownership & related parties

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Barton Memorial HospitalS Lake Tahoe, CA, CCN 050352 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2005
Carson Valley HealthGardnerville, NV, CCN 291306 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2000
Carson Valley HealthGardnerville, NV, CCN 29Z306 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 2008
Barton Memorial HospitalSouth Lake Tahoe, CA, CCN 555698 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 7, 1997
Apr 4, 1997
Mar 7, 1997
Barton Community Health CenterSouth Lake Tahoe, CA, CCN 058580 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2002
Aug 1, 2002
Carson Valley Health Primary Care Topaz RanchWellington, NV, CCN 293985 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2000

Owned or controlled facilities with NPI records 7

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

Practitioners & affiliated clinicians

Practitioners 81

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 81

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1467046102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-543-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HIGHWAY 50",
            "city": "STATELINE",
            "state": "NV",
            "postal_code": "894499816",
            "telephone_number": "530-543-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTON HEALTHCARE SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BARTON HEALTHCARE SYSTEM",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "530-543-5636"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stateline, NV

Sources for this page

Verify at the official NPI Registry.