Mountain Health & Community Services, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

090000135 Issued in CA

Legal business name

MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.

Doing business as

Mountain Empire Family Medicine

Practice address

31115 Highway 94
Campo, CA 91906-3133

Phone

(619) 478-5311

Fax

(619) 478-2267

NPI assigned

Dec 5, 2006

Last updated

May 8, 2017By 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

Judith Shaplin

Title

Ceo

Phone

(619) 445-6200

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mountain Empire Family Medicine Doing business as

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1881752608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31115 HIGHWAY 94",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919063133",
            "telephone_number": "619-478-5254",
            "fax_number": "619-478-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31115 HIGHWAY 94",
            "city": "CAMPO",
            "state": "CA",
            "postal_code": "919063133",
            "telephone_number": "619-478-5311",
            "fax_number": "619-478-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "SHAPLIN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-445-6200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "090000135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PROGRAM",
            "identifier": "HAP03814F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PROGRAM",
            "identifier": "BCP03814F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC03814F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Empire Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marco Martinez, RADT
• Richard Martinez
• William Christopher May, RADT
• Elizabeth Pauline Moreno, CCMA
• Mountain Health & Community Services, Inc. (Mountain Health Family Medicine)
• Mountain Health & Community Services, Inc.
• Garikai Moyo, RN
• Timothy Nelson, RADT
• Hai Ho Nguyen
• James Francis Nourie, RADT-I

• Federally Qualified Health Center (FQHC) in Campo, CA
• Providers in Campo, CA by specialty
• Federally Qualified Health Center (FQHC) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.