NPIMap

Organization Active NPI

Premise Health of California Medical PC

Doing business as Jackson Rancheria Medical Center

  • Multi-Specialty Clinic/Center
  • Jackson, CA
National Provider Identifier
1619441128
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF CALIFORNIA MEDICAL PC
Doing business as
Jackson Rancheria Medical Center
Practice address
12222 New York Ranch Rd
Jackson, CA 95642-9407
Phone
(209) 223-8428
Fax
(209) 223-8429
NPI assigned
Jan 17, 2019
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Edward William Schwartz
Title
President
Phone
(844) 407-7557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

12222 New York Ranch Rd
Jackson, CA 95642-9407

Mailing address

5500 Maryland Way Ste 200
Brentwood, TN 37027-4973

Other names 1

  • Jackson Rancheria Medical Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2074377Jackson Rancheria Medical Center12222 New York Ranch Rd, Jackson, CA 95642Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of California Medical PC55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

12222 New York Ranch Rd
Jackson, CA 95642
Phone (209) 223-8428

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1619441128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 NEW YORK RANCH RD",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429407",
            "telephone_number": "209-223-8428",
            "fax_number": "209-223-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF CALIFORNIA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-17",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "SCHWARTZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "844-407-7557"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Rancheria Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Rancheria Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.