NPIMap

Organization Active NPI

Prime Healthcare Services - Shasta LLC

Doing business as Shasta Regional Medical Group Palo Cedro

  • Rural Health Clinic/Center
  • Palo Cedro, CA
National Provider Identifier
1760278436
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PRIME HEALTHCARE SERVICES - SHASTA LLC
Doing business as
Shasta Regional Medical Group Palo Cedro
Practice address
9180 Deschutes Rd
Palo Cedro, CA 96073-8716
Phone
(530) 244-5400
NPI assigned
Apr 17, 2025
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

9180 Deschutes Rd
Palo Cedro, CA 96073-8716

Mailing address

1100 Butte St
Redding, CA 96001-0852
Phone (530) 244-5400

Other names 1

  • Shasta Regional Medical Group Palo Cedro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services - Shasta LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1760278436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BUTTE ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010852",
            "telephone_number": "530-244-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9180 DESCHUTES RD",
            "city": "PALO CEDRO",
            "state": "CA",
            "postal_code": "960738716",
            "telephone_number": "530-244-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES - SHASTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shasta Regional Medical Group Palo Cedro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palo Cedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.