Active NPI
Rickey Lee Southwell Jr., PA-C
- Physician Assistant
- Redding, CA
National Provider Identifier
1952811051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 54920
- Practice address
- 1742 Oregon St
Redding, CA 96001-1717 - Phone
- (530) 646-7269
- NPI assigned
- Oct 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 54920 | CA | Primary |
Addresses
Primary practice location
1742 Oregon St
Redding, CA 96001-1717
Mailing address
2400 Washington Ave Ste 100
Redding, CA 96001-2814
Phone (530) 530-2267
Other practice location 1
420 S Main St
Red Bluff, CA 96080-4316
Phone (530) 999-2014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1742 Oregon St
Redding, CA 96001-1717
Phone (530) 646-7269
420 S Main St
Red Bluff, CA 96080-4316
Phone (888) 297-8080
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54920 | CA | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rolling Hills Clinic | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba North American Mental Health Services
- Psychiatry Physician
- Redding, CA
- NPI 1073919171
-
- Federally Qualified Health Center (FQHC)
- Red Bluff, CA
- NPI 1679988950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1952811051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 WASHINGTON AVE STE 100",
"city": "REDDING",
"state": "CA",
"postal_code": "960012814",
"telephone_number": "530-530-2267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1742 OREGON ST",
"city": "REDDING",
"state": "CA",
"postal_code": "960011717",
"telephone_number": "530-646-7269"
}
],
"practiceLocations": [
{
"address_1": "420 S Main St",
"address_purpose": "LOCATION",
"city": "Red Bluff",
"state": "CA",
"postal_code": "960804316",
"country_code": "US",
"telephone_number": "530-999-2014",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOUTHWELL",
"first_name": "RICKEY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-04",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "54920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.