NPIMap

Organization Active NPI

Eastern Plumas Health Care District

Doing business as Eastern Plumas Health Care

  • Rural Health Clinic/Center
  • Loyalton, CA
National Provider Identifier
1669478590
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
058597 Issued in CA
Legal business name
EASTERN PLUMAS HEALTH CARE DISTRICT
Doing business as
Eastern Plumas Health Care
Practice address
700 Third Ave
Loyalton, CA 96118
Phone
(530) 832-6500
Fax
(530) 832-1105
NPI assigned
Jun 24, 2005
Last updated
Dec 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Authorized official

Name
Ms. Jerilee Nelson, CPA
Title
Cfo
Phone
(530) 832-6578

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 058597 CA Primary
Rural Health Clinic/Center 261QR1300X 230000014 CA
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

700 Third Ave
Loyalton, CA 96118

Mailing address

500 1St Ave
Portola, CA 96122-9406
Phone (530) 832-6500

Other identifiers 2

IdentifierTypeStateIssuer
ZZZC4600ZOtherCABLUE SHIELD
RHM08597FMedicaidCA

Other names 1

  • EASTERN PLUMAS HEALTH CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000694 CA Part A Provider - Rural Health Clinic 4587576889 Practice locations: Loyalton, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669478590. Details of each certification follow.

Rural health clinic certification: CCN 058597

Legal name
EASTERN PLUMAS HEALTH CARE DISTRICT
Doing business as
EASTERN PLUMAS HEALTH CARE DISTRICT
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 2, 2003
Last certification
Jun 28, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 5, 1991 in CA
Enrollment address
701 Main St
Loyalton, CA 96118-5744
Related CCNs
051300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eastern Plumas Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marcia Hughes Individual Corporate DirectorDirector on the Board of Directors Dec 1, 2022
Gail McGrath Individual Corporate DirectorDirector Dec 5, 2014
Teresa Whitfield Individual Corporate DirectorBoard Member Dec 2, 2018
Douglas McCoy Individual Corporate OfficerChief Executive Officer May 14, 2020
W-2 Managing EmployeeChief Executive Officer May 14, 2020
Paul S Swanson Individual Corporate Director Dec 7, 2016
Katherine a Pairish Individual Corporate OfficerCfo Nov 1, 2017
W-2 Managing EmployeeCfo Nov 1, 2017
Linda Satchwell Individual Corporate Director Jan 1, 2021
Augustine Corcoran Individual Corporate DirectorDirector Jan 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eastern Plumas Health CarePortola, CA, CCN 051300 Hospital Operational/Managerial Control Oct 24, 2000
Eastern Plumas Health CarePortola, CA, CCN 555433 Skilled nursing facility Other Sep 11, 1990
Eastern Plumas Health Care DistrictGraeagle, CA, CCN 553985 Rural health clinic Other Jan 1, 2013
Portola Medical ClinicPortola, CA, CCN 058522 Rural health clinic Other Jan 1, 2013

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671580800000",
    "number": "1669478590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 1ST AVE",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961229406",
            "telephone_number": "530-832-6500",
            "fax_number": "530-832-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 THIRD AVE",
            "city": "LOYALTON",
            "state": "CA",
            "postal_code": "96118",
            "telephone_number": "530-832-6500",
            "fax_number": "530-832-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PLUMAS HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JERILEE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-832-6578",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "058597",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "230000014",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZC4600Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08597F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTERN PLUMAS HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EASTERN PLUMAS HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loyalton, CA

Sources for this page

Verify at the official NPI Registry.