NPIMap

Organization Active NPI

American Hospital Management

Doing business as Mad River Comm Hospital

  • General Acute Care Hospital
  • Arcata, CA
National Provider Identifier
1700092137
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
110000031 Issued in CA
Legal business name
AMERICAN HOSPITAL MANAGEMENT
Doing business as
Mad River Comm Hospital
Practice address
3800 Janes Rd
Arcata, CA 95521-4742
Phone
(707) 822-3621
Fax
(707) 822-8258
NPI assigned
May 15, 2007
Last updated
Sep 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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

Authorized official

Name
Douglas Allen Shaw
Title
Chief Executive Officer
Phone
(707) 822-7220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 110000031 CA Primary

Addresses

Primary practice location

3800 Janes Rd
Arcata, CA 95521-4742

Mailing address

PO Box 1115
Arcata, CA 95518-1115
Phone (707) 822-3621

Other identifiers 1

IdentifierTypeStateIssuer
HSP40028FMedicaidCA

Other names 1

  • MAD RIVER COMM HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mad River Comm HSP Emer4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1700092137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1115",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955181115",
            "telephone_number": "707-822-3621",
            "fax_number": "707-826-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES RD",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-822-3621",
            "fax_number": "707-822-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN HOSPITAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "707-822-7220"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "110000031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40028F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAD RIVER COMM HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MAD RIVER COMM HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.