SHINGLETOWN MEDICAL CENTER
NPI 1750387072
Clinic/Center - Federally Qualified Health Center (FQHC) in Shingletown, CA
NPI Status: Active since June 22, 2005
Contact Information
31292 ALPINE MEADOWS RD
SHINGLETOWN, CA
ZIP 96088
Phone: (530) 474-3390
Fax: (530) 474-4899
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 05D0618500
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2026
About SHINGLETOWN MEDICAL CENTER
This page provides the complete NPI Profile along with additional information for Shingletown Medical Center, a primary care provider established in Shingletown, California operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1750387072 assigned on June 2005. The practitioner's primary taxonomy code is 261QF0400X with license number 230000091 (CA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Tami Fraser (Ceo)
- NPI
- 1750387072
- Provider Name
- SHINGLETOWN MEDICAL CENTER
- Entity Type
- Organization
- Location Address
- 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088
- Location Phone
- (530) 474-3390
- Location Fax
- (530) 474-4899
- Mailing Address
- 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088
- Mailing Phone
- (530) 474-3390
- Mailing Fax
- (530) 474-4899
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-22-2005
- Last Update Date
- 06-22-2021
- Code Navigator
A primary care provider (PCP) like Shingletown Medical Center sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License No.
- 230000091
- License State
- CA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| FHC03870F | MEDICAID (05) | CA | |
| ZZZ30035Z | OTHER (01) | CA | BLUE SHIELD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0618500
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- STEVEN LICATA
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Shingletown Medical Center in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for SHINGLETOWN MEDICAL CENTER
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 3 | 8 | 7 | 0 | 7 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 6 | 8 | 14 | 0 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 6 + 8 + 1 + 4 + 0 + 1 + 4 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1750387072 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1306890025 | DR. ALBERT GORDON LUI MD Individual | Family Medicine | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1801978861 | MICHAEL SIMPSON FNP-C Individual | Nurse Practitioner (Family) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1316228125 | COLLEEN CAMBRA LCSW Individual | Social Worker (Clinical) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1932626058 | BETH GREENWOOD RN Individual | Registered Nurse (Administrator) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1891272340 | JANET ANN BARABE RN Individual | Registered Nurse (Community Health) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1992273403 | ARLENE M SHARP Individual | Registered Nurse (Community Health) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1467893032 | MRS. NICOLE LANE CLARK LCSW Individual | Counselor (Mental Health) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1265680540 | DELAINA MARIE JEWKES M.D. Individual | Psychiatry & Neurology (Psychiatry) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1922726819 | TRACY HIGGINS Individual | Nurse Practitioner (Family) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1750006730 | KIMBERLY JEAN MALSON RN Individual | Registered Nurse | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-2290 |
| 1487479812 | JOHN CROWE RN Individual | Registered Nurse | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
| 1053902130 | SIMRANJOT KAUR THIND Individual | Nurse Practitioner (Primary Care) | 31292 ALPINE MEADOWS RD SHINGLETOWN, CA 96088 (530) 474-3390 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750387072, enumerated in the NPI registry as an "organization" on June 22, 2005
The provider is located at 31292 Alpine Meadows Rd Shingletown, Ca 96088 and the phone number is (530) 474-3390
This medical organization specializes in Clinic/Center with taxonomy code 261QF0400X with a focus in Federally Qualified Health Center (FQHC)
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 05D0618500 for a "federally qualified health center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on June 22, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.