NPIMap

Organization Active NPI

Southern Mono Health Care District

Doing business as Mammoth Hospital Physician Group

  • Critical Access Hospital
  • Mammoth Lakes, CA
National Provider Identifier
1700117462
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
240000008 Issued in CA
Legal business name
SOUTHERN MONO HEALTH CARE DISTRICT
Doing business as
Mammoth Hospital Physician Group
Practice address
85 Sierra Park Road
Mammoth Lakes, CA 93546-0660
Phone
(760) 872-6749
Fax
(760) 872-6790
NPI assigned
Jan 20, 2010
Last updated
Jan 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Authorized official

Name
Mr. Gary Boyd
Title
Chief Executive Officer
Phone
(760) 934-3311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 240000008 CA Primary
Rural Acute Care Hospital 282NR1301X 240000008 CA

Addresses

Primary practice location

85 Sierra Park Road
Mammoth Lakes, CA 93546-0660

Mailing address

PO Box 660
Mammoth Lakes, CA 93546-0660
Phone (760) 872-6749

Other names 1

  • Mammoth Hospital Physician Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Mono Healthcare District9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1700117462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460660",
            "telephone_number": "760-872-6749",
            "fax_number": "760-872-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK ROAD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460660",
            "telephone_number": "760-872-6749",
            "fax_number": "760-872-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MONO HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "760-934-3311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "240000008",
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "CA",
            "license": "240000008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mammoth Hospital Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mammoth Lakes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.