NPIMap

Organization Active NPI

Northern Inyo Associates

  • Clinic/Center
  • Bishop, CA
National Provider Identifier
1649664848
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHERN INYO ASSOCIATES
Practice address
152 Pioneer LN
Suite D
Bishop, CA 93514-2563
Phone
(760) 872-1606
Fax
(760) 872-3463
NPI assigned
Mar 25, 2015
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Christian Wallis
Title
Chief Executive Officer
Phone
(760) 873-2838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

152 Pioneer LN
Suite D
Bishop, CA 93514-2563

Mailing address

152 Pioneer LN
Bishop, CA 93514-2563
Phone (760) 873-5811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000652 CA Part B Supplier - Clinic/Group Practice 8921992090 Receives reassigned benefits from 129 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bishop, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
05D2147263Northern Inyo Associates Specialty Clinic152 Pioneer Lane, Suite F, Bishop, CA 93514Certificate of waiverApr 16, 2028

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

152 Pioneer Ln
Bishop, CA 93514
Phone (619) 873-7111

152 Pioneer Ln
Ste D
Bishop, CA 93514
Phone (760) 872-1606

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1649664848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-873-5811",
            "fax_number": "760-873-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "SUITE D",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-872-1606",
            "fax_number": "760-872-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN INYO ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "760-873-2838"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.