Shasta Regional Medical Group, Inc
Organization Active NPI Family Medicine Physician · Weed, CA
NPI 1588048680 · NPPES record last updated Aug 11, 2015
Key facts
- NPI
- 1588048680
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SHASTA REGIONAL MEDICAL GROUP, INC
- Practice address
- 50 Alamo Ave
Weed, CA 96094-2352 - Phone
- (530) 605-4263
- NPI assigned
- Jul 17, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- SHASTA REGIONAL MEDICAL GROUP, INC
Authorized official
- Name
- Danielle Elaina Cutlip
- Title
- Practice Manager
- Phone
- (530) 605-4263
Other NPIs on the same Medicare enrollment 1
Practitioners 65
-
Alicia Marjourie Adams, DNP, APRN, FNP-BC
-
Dimple Agarwal, M.D.
-
Thomas James Andrews, M.D.
-
Jose Luis Barrios Jr., M.D.
-
Amit Bawa, M.D.
-
Arvind Kaur Behl, M.D.
-
Simon CHI Yan Chan, M.D.
-
Prathibha Chandrasekaran, M.D.
-
Sara Choudhry, M.D.
-
Cynthia Reynolds Dillon, M.D.
-
Karen R Garnaas, MD
-
Patrick Keith Griffith, M.D.
-
Rachel McKenzie Haase, PMHNP-DNP
-
Khadija H Hamisi, NP
-
Raven Anne Jennings, FNP
-
Rachna Kalia, MD
-
Babak Kanani, M.D.
-
Haneen Abdussalam Khamag, M.D.
-
Imran Khan, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090310000251 | CA | Part B Supplier - Clinic/Group Practice | 5991861353 |
Receives reassigned benefits from 66 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Anderson, CA; Redding, CA |
National Provider Directory
- Part of
- Shasta Regional Med GRP Inc
Locations
1850 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 251-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
50 Alamo Ave
Weed, CA 96094-2352
Mailing address
50 Alamo Ave
Weed, CA 96094-2352
Phone (530) 605-4263
Other providers in Weed, CA
- Erika C Rosales
- Rural Medicine Direct
- Kirstin Schulze
- Theresa Marie Searles
- Shaca HC LLC
- Shasta View Estates, Inc.
- Jennifer Anne Shealy
- William Ryan Smith
- Harvey Joel Sternberg
- Sunbridge Care Enterprises West
All providers in Weed, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.