NPIMap

Organization Active NPI

Blue Shield Promise Healthplan

Doing business as Blue Shield Promise Primary and Urgent Care Lancaster

  • Primary Care Clinic/Center
  • Lancaster, CA
National Provider Identifier
1578214748
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BLUE SHIELD PROMISE HEALTHPLAN
Doing business as
Blue Shield Promise Primary and Urgent Care Lancaster
Practice address
44426 10TH Street West
Suite a
Lancaster, CA 93534
Phone
(661) 448-8910
Fax
(661) 948-2440
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Kristen Cerf
Title
President & Ceo Blue Shield Ca Prom
Phone
(510) 607-4376

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Primary Care Nurse Practitioner 363LP2300X
Pediatrics Physician 208000000X
Pain Medicine Physician 208VP0000X

Addresses

Primary practice location

44426 10TH Street West
Suite a
Lancaster, CA 93534

Mailing address

44426 10TH Street West
Suite a
Lancaster, CA 93534
Phone (661) 448-8910

Other names 1

  • Blue Shield Promise Primary and Urgent Care Lancaster Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blue Shield Promise Health Plan3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

44426 10th St W
#A
Lancaster, CA 93534
Phone (661) 448-8910

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1578214748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44426 10TH STREET WEST",
            "address_2": "SUITE A",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-448-8910",
            "fax_number": "661-948-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44426 10TH STREET WEST",
            "address_2": "SUITE A",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-448-8910",
            "fax_number": "661-948-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SHIELD PROMISE HEALTHPLAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "CERF",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "PRESIDENT & CEO BLUE SHIELD CA PROM",
        "authorized_official_telephone_number": "510-607-4376"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Shield Promise Primary and Urgent Care Lancaster",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.