NPIMap

Organization Active NPI

County of El Dorado

  • Prison Health Clinic/Center
  • Placerville, CA
National Provider Identifier
1962236414
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
COUNTY OF EL DORADO
Practice address
300 Forni Road
Placerville, CA 95667
Phone
(530) 621-6000
NPI assigned
Aug 28, 2024
Organization subpart
Yes
Parent organization
COUNTY OF EL DORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Jeff Leikauf
Title
Sheriff-Coroner-Public Administrato
Phone
(530) 621-5655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary

Addresses

Primary practice location

300 Forni Road
Placerville, CA 95667

Mailing address

200 Industrial Dr.
Placerville, CA 95667
Phone (530) 621-5655

Other names 1

  • El Dorado County Sheriff's Department Healthcare Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2142193El Dorado County, Placerville Main Jail300 Forni Road, Placerville, CA 95667Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
El Dorado County Ambula22 organizations share this tax ID, including this one
Part of
El Dorado County Ambula

Other organizations with this tax ID 21

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

View all 21

Locations

300 Forni Rd
Placerville, CA 95667
Phone (530) 621-6000

200 Industrial Dr
Placerville, CA 95667

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1962236414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 INDUSTRIAL DR.",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-621-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FORNI ROAD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "95667",
            "telephone_number": "530-621-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF EL DORADO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF EL DORADO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "LEIKAUF",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SHERIFF-CORONER-PUBLIC ADMINISTRATO",
        "authorized_official_telephone_number": "530-621-5655"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Dorado County Sheriff's Department Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.