Jack Warren Saunders, MD

Primary specialty

Personal Emergency Response AttendantTaxonomy code 146D00000X

License

G32096 Issued in CA

Practice address

914 Pine Street
Mount Shasta, CA 96067-2143

Phone

(530) 926-6111

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McCloud Healthcare Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • McCloud, CA
  • NPI 1164428488

  CA

  Medicare reassignment
• McCloud Healthcare Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dunsmuir, CA
  • NPI 1376893420
  NPD
• Mount Eddy Emergency Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Mount Shasta, CA
  • NPI 1316299787

  Emergency Medicine

  NPD (past)
• Valley Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • Mount Shasta, CA
  • NPI 1497849574

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1477564078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 12259",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852259",
            "telephone_number": "888-634-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 PINE STREET",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "JACK",
        "middle_name": "WARREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "CA",
            "license": "G32096",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G32096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G320960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Robinson, RPH
• Candace A Ross, MSW, LCSW, MAC, CCTP
• Karndeep Samran, MD
• Krista R Sanders, PPS-SC
• Kimberly Santi
• Steven J Scharpf, M.D.
• Robin See-Swenson, MFT
• Shanhong Lu
• Shasta Midwives Birth Center Inc
• Shasta Mountain Shuttle and Tours LLC

• All providers in Mount Shasta, CA
• Personal Emergency Response Attendant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.