Shasta Regional Medical Group Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

26633 Issued in CA

Legal business name

SHASTA REGIONAL MEDICAL GROUP INC

Doing business as

Shasta Community Medical Group

Practice address

1555 East St Ste 210
Redding, CA 96001-1153

Phone

(530) 244-8316

NPI assigned

May 14, 2009

Last updated

May 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Venkamma Reddy, M.D.NPI 1124077698

Title

President

Phone

(760) 241-8000

Specialties & licenses 2

Addresses

Other names 1

• SHASTA COMMUNITY MEDICAL GROUP Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Venkamma Reddy, MD

  • Internal Medicine Physician
  • Victorville, CA
  • NPI 1124077698
  Authorized official Same address or phone
• Riaz A Malik, M.D.

  • Surgery Physician
  • Redding, CA
  • NPI 1003837543
  NPD (past)

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1861626129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955794",
            "telephone_number": "760-241-8000",
            "fax_number": "760-962-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 EAST ST STE 210",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011153",
            "telephone_number": "530-244-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA REGIONAL MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VENKAMMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-241-8000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "26633",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "26633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHASTA COMMUNITY MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shasta Primary Care LLC
• 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 Community Medical Group)
• Shasta Sleep Services LLC
• Shasta Speech and Language Pathology Inc.
• Shasta Strong Massage and Wellness
• Shasta Treatment Associates
• Shasta Treatment Associates

• Vascular Surgery Physician in Redding, CA
• Providers in Redding, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.