I'Sot Inc

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

230000116 Issued in CA

Legal business name

I'SOT INC

Doing business as

Canby Family Practice Clinic

Practice address

670 County Road 83
Canby, CA 96015-9722

Phone

(530) 233-4641

Fax

(530) 233-4140

NPI assigned

Jun 20, 2005

Last updated

Sep 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Greta J Elliott

Title

Administrator

Phone

(530) 233-4641

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Canby Family Practice Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Last Frontier Healthcare District

  dba Canby Family Practice Clinic

  • Rural Health Clinic/Center
  • Canby, CA
  • NPI 1376164749

  Sold to, 2020-07-01

  CMS change of ownership

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1528063153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 COUNTY ROAD 83",
            "city": "CANBY",
            "state": "CA",
            "postal_code": "960159722",
            "telephone_number": "530-233-4641",
            "fax_number": "530-233-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 COUNTY ROAD 83",
            "city": "CANBY",
            "state": "CA",
            "postal_code": "960159722",
            "telephone_number": "530-233-4641",
            "fax_number": "530-233-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I'SOT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "GRETA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "530-233-4641",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "230000116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM03888F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "ZZZ21128Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canby Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lorna K Boland
• Susan Adele Burger
• Joey Chou-Yie Chen, D.D.S.
• Mickey Cole, R.D.H
• Virginia L Hassler, FNP
• Lake Health District (Lake Wound Clinic)
• Last Frontier Healthcare District (Canby Family Practice Clinic)
• Raymond P Mandel, PHD

• Rural Health Clinic/Center in Canby, CA
• Providers in Canby, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.