NPIMap

Organization Active NPI

Northern Valley Indian Health Inc

  • Clinic/Center
  • Woodland, CA
National Provider Identifier
1881960128
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHERN VALLEY INDIAN HEALTH INC
Practice address
175 W Court St
Woodland, CA 95695-2913
Phone
(530) 934-9293
Fax
(530) 934-2204
NPI assigned
Mar 30, 2012
Last updated
May 6, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Authorized official

Name
Theresa A Cameron
Title
Billing Coordinator
Phone
(530) 934-9293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

175 W Court St
Woodland, CA 95695-2913

Mailing address

207 N Butte St
Willows, CA 95988-2803
Phone (530) 934-9293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140429000114 TX Part B Supplier - Clinic/Group Practice 1557493723 Receives reassigned benefits from 102 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chico, CA; Willows, CA
O20150121000010 CA Part A Provider - Indian Health Services Facility 1557493723 Practice locations: Woodland, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881960128. Details of each certification follow.

  • CCN 051925 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 051925

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NORTHERN VALLEY INDIAN HEALTH, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1993
Last certification
Oct 1, 1993
Ownership / control type
Non-profit – other
Facility address
175 W Court Street
Woodland, CA 95695

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northern Valley Indian Health Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

175 W Court St
Woodland, CA 95695
Phone (530) 661-4400

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northern Valley Indian Health IncWillows, CA, CCN 051924 Federally qualified health center Operational/Managerial Control Oct 1, 1991

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367798400000",
    "number": "1881960128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BUTTE ST",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882803",
            "telephone_number": "530-934-9293",
            "fax_number": "530-934-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W COURT ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952913",
            "telephone_number": "530-934-9293",
            "fax_number": "530-934-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VALLEY INDIAN HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2013-05-06",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "530-934-9293"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.