Caryn Kendra Slack, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C152597 Issued in CA

Practice address

199 Twin Lakes Rd
Bridgeport, CA 93517-8050

Phone

(530) 495-2100

Fax

(530) 495-2100

NPI assigned

Jun 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Minnesota Medical School, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Toiyabe Indian Health Project IncGroup PAC ID 2668419813, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Valley Health Hospital, Gardnerville, NV, CCN 291306
• Northern Inyo Hospital Hospital, Bishop, CA, CCN 051324
• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: cslack502856@direct.memorialcare.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: caryn.slacker.p1@direct.toiyabe.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Toiyabe Indian Health Project, Inc

  • Federally Qualified Health Center (FQHC)
  • Bishop, CA
  • NPI 1659433191
  Medicare reassignment Care Compare group NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hawthorne, CA
  • NPI 1164914115
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Toiyabe Indian Health Project, Inc

  • Clinic Pharmacy
  • Bishop, CA
  • NPI 1093720609
  NPD
• The Childrens Clinic 'Serving Children and Their Families'

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1881150548
  NPD (past)
• Jordan Family Health, LLC

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1164672770
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barton Healthcare System

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation
• Northern Inyo Healthcare District

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  • Community/Behavioral Health Agency
  • Gardnerville, NV
  • NPI 1104482918

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  • Critical Access Hospital
  • Gardnerville, NV
  • NPI 1396799102
  Care Compare affiliation

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1689619124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SEE VEE LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935148130",
            "telephone_number": "760-873-8464",
            "fax_number": "760-503-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 TWIN LAKES RD",
            "city": "BRIDGEPORT",
            "state": "CA",
            "postal_code": "935178050",
            "telephone_number": "530-495-2100",
            "fax_number": "530-495-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 N See Vee Ln",
            "address_purpose": "LOCATION",
            "city": "Bishop",
            "state": "CA",
            "postal_code": "935148130",
            "country_code": "US",
            "telephone_number": "760-873-8461",
            "fax_number": "760-873-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLACK",
        "first_name": "CARYN",
        "middle_name": "KENDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C152597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "THP11576F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naval Hospital Twentynine Palms
• Amanda Philips
• Duane E Postler, IDC
• Michael Dale Richardson
• Tommy Savedra, PA
• Southern Mono Health Care District
• Catherine Nicole Thomas, MD
• William Douglas Todd, P.A-C
• Greg Urick

• Family Medicine Physician in Bridgeport, CA
• Providers in Bridgeport, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.