NPIMap

Organization Active NPI

North Valley Breast Clinic

  • Medical Specialty Clinic/Center
  • Redding, CA
National Provider Identifier
1841494366
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
NORTH VALLEY BREAST CLINIC
Practice address
1335 Buenaventura Blvd
Suite # 204
Redding, CA 96001-0160
Phone
(530) 243-5551
Fax
(530) 245-0572
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Authorized official

Name
Dr. Ian P Grady, MDNPI 1215951371
Title
Owner
Phone
(530) 243-5551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1335 Buenaventura Blvd
Suite # 204
Redding, CA 96001-0160

Mailing address

1335 Buenaventura Blvd
Suite # 204
Redding, CA 96001-0160
Phone (530) 243-5551

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ53955YOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1335 Buenaventura Blvd
Redding, CA 96001
Phone (530) 243-5551

1335 Buenaventura Blvd
Ste 204
Redding, CA 96001
Phone (530) 243-5551

8550 Santa Monica Blvd
Fl 2
West Hollywood, CA 90069
Phone (833) 477-2775

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BCDABD

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1841494366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 BUENAVENTURA BLVD",
            "address_2": "SUITE # 204",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010160",
            "telephone_number": "530-243-5551",
            "fax_number": "530-245-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 BUENAVENTURA BLVD",
            "address_2": "SUITE # 204",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010160",
            "telephone_number": "530-243-5551",
            "fax_number": "530-245-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VALLEY BREAST CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "IAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-243-5551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ53955Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.