NPIMap

Organization Active NPI

Ccmma Ca PC

  • Critical Care Medicine (Anesthesiology) Physician
  • Redding, CA
National Provider Identifier
1679293443
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
Legal business name
CCMMA CA PC
Practice address
1100 Butte St
Redding, CA 96001-0852
Phone
(530) 244-5400
Fax
(888) 220-6560
NPI assigned
Aug 31, 2022
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Laurie Laduca
Title
Credentialing Manager
Phone
(845) 702-2711

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LC0200X Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

1100 Butte St
Redding, CA 96001-0852

Mailing address

PO Box 631917
Cincinnati, OH 45263-1917
Phone (845) 702-2711

Other practice location 1

201 NW R D Mize Rd
Blue Springs, MO 64014-2513
Phone (816) 228-5900

Other practice location 2

1749 Sonoma Ave
Berkeley, CA 94707-2547
Phone (845) 702-2711

Other practice location 3

120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-3770

Other practice location 4

2 Park Ave Ste 2039
New York, NY 10016-5675
Phone (845) 702-2711

Other practice location 5

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

Other practice location 6

425 W 5th St
East Liverpool, OH 43920-2498
Phone (330) 385-7200

Other practice location 7

600 S Monroe St
Enid, OK 73701-7211
Phone (580) 233-2300

Other practice location 8

129 N Washington St
Sumter, SC 29150-4949
Phone (803) 774-9000

Other practice location 9

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221028002534 CA Part B Supplier - Clinic/Group Practice 5991172207 Receives reassigned benefits from 47 practitioners
Practice locations: Hacienda Heights, CA; Los Angeles, CA; Napa, CA; Palm Springs, CA; Redding, CA; Roseville, CA; San Diego, CA; San Francisco, CA…
O20221129003540 TX Part B Supplier - Clinic/Group Practice 5991172207 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

12500 South Fwy
Ste 100
Burleson, TX 76028
Phone (214) 294-6250

8230 N Loop 1604 W
Ste 100
San Antonio, TX 78249

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1679293443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631917",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631917",
            "telephone_number": "845-702-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BUTTE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010852",
            "telephone_number": "530-244-5400",
            "fax_number": "888-220-6560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 NW R D Mize Rd",
            "address_purpose": "LOCATION",
            "city": "Blue Springs",
            "state": "MO",
            "postal_code": "640142513",
            "country_code": "US",
            "telephone_number": "816-228-5900",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1749 Sonoma Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947072547",
            "country_code": "US",
            "telephone_number": "845-702-2711",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 N Delaware St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "MI",
            "postal_code": "484711009",
            "country_code": "US",
            "telephone_number": "810-648-3770",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Park Ave Ste 2039",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100165675",
            "country_code": "US",
            "telephone_number": "845-702-2711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070552840",
            "country_code": "US",
            "telephone_number": "973-365-4300",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 W 5th St",
            "address_purpose": "LOCATION",
            "city": "East Liverpool",
            "state": "OH",
            "postal_code": "439202498",
            "country_code": "US",
            "telephone_number": "330-385-7200",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 S Monroe St",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737017211",
            "country_code": "US",
            "telephone_number": "580-233-2300",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "129 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291504949",
            "country_code": "US",
            "telephone_number": "803-774-9000",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "713-790-3311",
            "fax_number": "888-220-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CCMMA CA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-31",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LADUCA",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "845-702-2711"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.