Active NPI
Western Sierra Medical Clinic, Inc.
- Urgent Care Clinic/Center
- Downieville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- License
- 230000145
- Legal business name
- WESTERN SIERRA MEDICAL CLINIC, INC.
- Practice address
- 209 Nevada Street
Downieville, CA 95936-0286 - Phone
- (530) 289-3298
- Fax
- (530) 289-3159
- NPI assigned
- May 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Francine Novak
- Title
- Pdo
- Phone
- (530) 802-2706
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | |||
| Urgent Care Clinic/Center | 261QU0200X | 230000145 | CA | Primary |
Addresses
Primary practice location
209 Nevada Street
Downieville, CA 95936-0286
Mailing address
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone (530) 289-3298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC03800F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 6
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040923000686 | CA | Part B Supplier - Clinic/Group Practice | 3971571217 |
Receives reassigned benefits from 58 practitioners 1 other NPI on this enrollment Practice locations: Auburn, CA; Downieville, CA; Grass Valley, CA; Kings Beach, CA; Penn Valley, CA |
| O20091221000137 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Downieville, CA |
| O20161018001783 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Penn Valley, CA |
| O20210728001908 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Grass Valley, CA |
| O20240102000808 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Auburn, CA |
| O20240102001000 | CA | Part A Provider - Federally Qualified Health Center (FQHC) | 3971571217 | Practice locations: Auburn, CA |
Federally qualified health center certification: CCN 051895
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Doing business as
- WESTERN SIERRA MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 1993
- Last certification
- Jul 1, 1993
- Ownership / control type
- For profit – corporation
- Most recent change of ownership
- Jun 30, 2010 (1 total)
- Organization structure
- Corporation
- Incorporated
- Aug 24, 1976 in CA
- Enrollment address
- 209 Nevada St
Downieville, CA 95936-0286
Federally qualified health center certification: CCN 921083
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 30, 2016
- Last certification
- Sep 30, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Aug 24, 1976 in CA
- Enrollment address
- 10544 Spenceville Rd
Penn Valley, CA 95946-9623
Federally qualified health center certification: CCN 921988
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 28, 2021
- Last certification
- Jul 28, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Feb 21, 1975 in CA
- Enrollment address
- 150 Glasson Way
Grass Valley, CA 95945-5706
Federally qualified health center certification: CCN A01825
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Doing business as
- WESTERN SIERRA MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 14, 2023
- Last certification
- Dec 14, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Feb 21, 1975 in CA
- Enrollment address
- 3257 Professional Dr
Ste C
Auburn, CA 95602-2460
Federally qualified health center certification: CCN A01826
- Legal name
- WESTERN SIERRA MEDICAL CLINIC INC
- Doing business as
- WESTERN SIERRA MEDICAL CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 14, 2023
- Last certification
- Dec 14, 2023
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Feb 21, 1975 in CA
- Enrollment address
- 11720 Education St
Ste 3
Auburn, CA 95602-2419
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Federally Qualified Health Center (FQHC)
- Grass Valley, CA
- NPI 1063496396
3971571217
-
- Federally Qualified Health Center (FQHC)
- Nevada City, CA
- NPI 1427827161
3971571217
-
- Federally Qualified Health Center (FQHC)
- Oregon House, CA
- NPI 1780463257
3971571217
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Federally Qualified Health Center (FQHC)
- Grass Valley, CA
- NPI 1063496396
O20040923000686
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0617228 | Western Sierra Medical Clinic | Certificate of waiver | Aug 21, 2027 |
National Provider Directory
National Provider DirectoryLocations
11720 Education St
Ste 3
Auburn, CA 95602
Phone (530) 274-9762
10544 Spenceville Rd
#340B126200
Penn Valley, CA 95946
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lupe R Peterson | Corporate Officer | Jan 1, 2010 | |
| Peter Scott Browne | Corporate Officer | Jan 1, 2010 | |
| Corporate Officer | Jan 1, 2010 | ||
| Corporate Officer | Dec 19, 2009 | ||
| Donald S Russell | Corporate Officer | Apr 27, 2011 | |
| Corporate Officer | Apr 27, 2011 | ||
| Brandon Pangman | Corporate Officer | Jan 1, 2010 | |
| Corporate Officer | Jan 1, 2010 | ||
| Jessica Lance | Corporate Officer | Apr 1, 2020 | |
| W-2 Managing Employee | Apr 1, 2020 | ||
| Contracted Managing Employee | Mar 1, 2022 | ||
| 5% Or Greater Indirect Ownership Interest | Mar 1, 2022 | ||
| Corporate Officer | Apr 1, 2020 | ||
| Derek M Williams | Corporate Officer | Jul 27, 2011 | |
| Corporate Officer | Jul 27, 2011 | ||
| Anita Daniels | Corporate Officer | Jan 1, 2010 | |
| Corporate Officer | Dec 19, 2009 | ||
| Corporate Officer | Dec 19, 2009 | ||
| Jonathan E Peck | Corporate Officer | May 23, 2012 | |
| Jennifer Malone | Corporate Officer | Jul 13, 2020 | |
| W-2 Managing Employee | Jul 13, 2020 | 100% | |
| Corporate Officer | Apr 1, 2020 | ||
| Francine Novak | Operational/Managerial Control | Apr 1, 2021 | |
| Noel Chapman | W-2 Managing Employee | Nov 29, 2016 |
Practitioners & affiliated clinicians
Practitioners 77
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ambulatory Women's Health Care Registered Nurse
- Grass Valley, CA
- NPI 1013571231
CA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773878400000",
"number": "1851513469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "844 OLD TUNNEL RD",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959458524",
"telephone_number": "530-289-3298",
"fax_number": "530-289-3159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 NEVADA STREET",
"city": "DOWNIEVILLE",
"state": "CA",
"postal_code": "959360286",
"telephone_number": "530-289-3298",
"fax_number": "530-289-3159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTERN SIERRA MEDICAL CLINIC, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-03",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A",
"authorized_official_last_name": "NOVAK",
"authorized_official_first_name": "FRANCINE",
"authorized_official_title_or_position": "PDO",
"authorized_official_telephone_number": "530-802-2706",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "CA",
"license": "230000145",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC03800F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Downieville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.