Active NPI
Shasta Emergency Medical Group
- Emergency Medicine Physician
- Red Bluff, CA
National Provider Identifier
1639196470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- SHASTA EMERGENCY MEDICAL GROUP
- Practice address
- 2550 Sister Mary Columba Dr
Red Bluff, CA 96080-4327 - Phone
- (530) 529-8000
- Fax
- (818) 587-2493
- NPI assigned
- Jul 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert S Hamilton, MD
- Title
- Director
- Phone
- (530) 529-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
2550 Sister Mary Columba Dr
Red Bluff, CA 96080-4327
Mailing address
PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0071480 | Medicaid | CA | |
| ZZZ52746Z | Other | CA | BLUE SHIELD |
| CT0220 | Other | CA | RAILROAD MEDICARE |
National Provider Directory
National Provider Directory- Tax ID family
- Shasta Emergency Medical Group
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Emergency Medicine Physician
- Redding, CA
- NPI 1548214943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1639196470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4419",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913654419",
"telephone_number": "818-340-9988",
"fax_number": "818-587-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 SISTER MARY COLUMBA DR",
"city": "RED BLUFF",
"state": "CA",
"postal_code": "960804327",
"telephone_number": "530-529-8000",
"fax_number": "818-587-2493"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHASTA EMERGENCY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HAMILTON",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "530-529-8000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0071480",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ52746Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CT0220",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bluff, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.