Shasta Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SHASTA PRIMARY CARE LLC

Practice address

2121 Airpark Dr
Redding, CA 96001-2433

Phone

(530) 255-8025

Fax

(530) 255-8028

NPI assigned

Nov 3, 2021

Organization subpart

No

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

Authorized official

Name

Shauni Vonice Williams, FNP-CNPI 1952957474

Title

Rendering Provider/Founder

Phone

(530) 949-7860

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shauni Vonice Williams, NP-C

  • Family Nurse Practitioner
  • Redding, CA
  • NPI 1952957474
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680393600000",
    "number": "1740945906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-255-8025",
            "fax_number": "530-255-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 AIRPARK DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012433",
            "telephone_number": "530-255-8025",
            "fax_number": "530-255-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2023-04-02",
        "certification_date": "2023-04-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHAUNI",
        "authorized_official_middle_name": "VONICE",
        "authorized_official_title_or_position": "RENDERING PROVIDER/FOUNDER",
        "authorized_official_telephone_number": "530-949-7860",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE FILE NUMBER",
            "identifier": "202129410899",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000694320",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CA376666",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.shastaprimarycare.com",
            "affiliation": "N",
            "endpointDescription": "website address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2121 Airpark Dr",
            "city": "Redding",
            "state": "CA",
            "country_code": "US",
            "postal_code": "960012433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shasta Medical Equipment
• Shasta Medical Lab
• Shasta Nutrition Services
• Shasta Orthopedics & Sports Medicine a Medical Corporation
• Shasta Physical Therapy
• Shasta Professional Eye Care Center, Doctors of Optometry, Inc.
• Shasta Regional Emergency Medical Associates, Inc
• Shasta Regional Medical Center, LLC
• Shasta Regional Medical Group Inc
• Shasta Regional Medical Group Inc

• Primary Care Clinic/Center in Redding, CA
• Providers in Redding, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2023; 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.