NPIMap

Organization Active NPI

County of Merced

  • Clinical Medical Laboratory
  • Merced, CA
National Provider Identifier
1942402672
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
COUNTY OF MERCED
Practice address
260 E 15TH St
Merced, CA 95340-6216
Phone
(209) 381-1200
Fax
(209) 381-1215
NPI assigned
Jun 4, 2007
Last updated
Oct 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Authorized official

Name
Mr. Kenneth Havens
Title
Fiscal Manager
Phone
(209) 381-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

260 E 15TH St
Merced, CA 95340-6216

Mailing address

260 E 15TH St
Merced, CA 95340-6216
Phone (209) 381-1200

Other identifiers 1

IdentifierTypeStateIssuer
LAB00866FMedicaidCA

Other names 1

  • Merced County Lab Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000468 CA Part B Supplier - Clinic/Group Practice 0941107973 Receives reassigned benefits from 5 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Merced, CA; Los Banos, CA; Livingston, CA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Merced Comm Med Plastic45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

Locations

260 E 15th St
Merced, CA 95341
Phone (209) 381-1200

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1942402672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953406216",
            "telephone_number": "209-381-1200",
            "fax_number": "209-381-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 E 15TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953406216",
            "telephone_number": "209-381-1200",
            "fax_number": "209-381-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MERCED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "HAVENS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "209-381-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB00866F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Merced County Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.