NPIMap

Organization Active NPI

Open Door Community Health Centers

Doing business as Perinatal Services of NorthCountry Clinic

  • Federally Qualified Health Center (FQHC)
  • Arcata, CA
National Provider Identifier
1922318047
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550001438 Issued in CA
Legal business name
OPEN DOOR COMMUNITY HEALTH CENTERS
Doing business as
Perinatal Services of NorthCountry Clinic
Practice address
3800 Janes Rd Ste 101
Arcata, CA 95521-4742
Phone
(707) 822-1385
Fax
(707) 825-8203
NPI assigned
Oct 8, 2010
Last updated
Jun 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Victor Starr
Title
President/Ceo
Phone
(707) 826-8633

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Federally Qualified Health Center (FQHC) 261QF0400X 550001438 CA Primary
Obstetrics Physician 207VX0000X

Addresses

Primary practice location

3800 Janes Rd Ste 101
Arcata, CA 95521-4742

Mailing address

1275 8TH St
Arcata, CA 95521-5770
Phone (707) 826-8633

Other names 1

  • Perinatal Services of NorthCountry Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040414000890 CA Part B Supplier - Clinic/Group Practice 9436067485 Receives reassigned benefits from 211 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arcata, CA; Willow Creek, CA; McKinleyville, CA; Fortuna, CA; Ferndale, CA; Eureka, CA; Crescent City, CA
O20110623000541 CA Part A Provider - Federally Qualified Health Center (FQHC) 9436067485 Practice locations: Arcata, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922318047. Details of each certification follow.

Federally qualified health center certification: CCN 551099

Legal name
OPEN DOOR COMMUNITY HEALTH CENTERS
Doing business as
PERINATAL SERVICES OF NORTHCOUNTRY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 24, 2011
Last certification
Jun 24, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jan 18, 1971 in CA
Enrollment address
3800 Janes Rd
# 101
Arcata, CA 95521-4742

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 12

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

National Provider Directory

National Provider Directory

Locations

785 18th St
Arcata, CA 95521
Phone (707) 822-2481

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Victor a Starr Individual Corporate OfficerPresident and Executive Officer Jan 7, 2020
W-2 Managing EmployeePresident and Executive Officer Jan 7, 2020
Heather S Snow Individual Corporate DirectorBoard Member Jul 26, 2021
John Driscoll Individual Corporate DirectorBoard Member Jul 26, 2021
Lindsay Righter Individual Corporate DirectorBoard Member Jan 1, 2012
Sarah Kerr Individual Corporate OfficerVice President of Operations North Jun 5, 2015
W-2 Managing EmployeeVice President of Operations North Jun 5, 2015
Felicia Oldfather Individual Corporate DirectorBoard Treasurer Jan 1, 2002
Kathleen Moxon Individual Corporate DirectorBoard President May 1, 1992
Neal Sanders Individual Corporate DirectorBoard Member Jan 1, 1998
Stacy Watkins Individual Corporate OfficerVice President of Administration May 30, 2007
W-2 Managing EmployeeVice President of Administration Mar 9, 2005
Sydney Fisher Larson Individual Corporate DirectorBoard Secretary Jul 1, 1999
Connie E Stewart Individual Corporate DirectorBoard Member Mar 1, 2009
Alison Talbot Individual Corporate DirectorBoard Vice President Jan 1, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1922318047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 8TH ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955215770",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 JANES RD STE 101",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955214742",
            "telephone_number": "707-822-1385",
            "fax_number": "707-825-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-826-8633"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550001438",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perinatal Services of NorthCountry Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perinatal Services of NorthCountry Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcata, CA

Sources for this page

Verify at the official NPI Registry.