NPIMap

Organization Active NPI

Occupational Health Services of Mad River

  • Occupational Medicine Clinic/Center
  • Arcata, CA
National Provider Identifier
1912083171
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
OCCUPATIONAL HEALTH SERVICES OF MAD RIVER
Practice address
3800 Janes Rd
Shaw Medical Pavilion
Arcata, CA 95521-4742
Phone
(707) 825-4907
Fax
(707) 825-4908
NPI assigned
Oct 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael J Young
Title
Cfo
Phone
(707) 826-8203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Clinic/Center 261QX0100X CA Primary

Addresses

Primary practice location

3800 Janes Rd
Shaw Medical Pavilion
Arcata, CA 95521-4742

Mailing address

PO Box 4696
Arcata, CA 95518-4696
Phone (707) 825-4907

National Provider Directory

National Provider Directory
Tax ID family
Mad River Comm HSP Ekg4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912083171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4696",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955184696",
            "telephone_number": "707-825-4907",
            "fax_number": "707-825-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES RD",
            "address_2": "SHAW MEDICAL PAVILION",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-825-4907",
            "fax_number": "707-825-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL HEALTH SERVICES OF MAD RIVER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-826-8203"
    },
    "taxonomies": [
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcata, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.