MCCLOUD HEALTHCARE CLINIC, INC. (NPI# 1003372624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003372624 |
| Entity Type | Organization |
| Organization Name | MCCLOUD HEALTHCARE CLINIC, INC. |
| Practice Address |
828 Pine St Mount Shasta CA 96067-2137 |
| Mailing Address |
Po Box 1143 Mccloud CA 96057-1143 |
| Practice Telephone | 5309264528 |
| Mailing Telephone | 5309642389 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| Authorized Official Name | JAMES PROFFITT (CEO) |
| Authorized Official Telephone | 5309642389 |
| Is Organization Subpart | Y |
| Parent Organization Name | MCCLOUD HEALTHCARE CLINIC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471B0102X |
Radiologic Technologist Specialization: Bone Densitometry |
Technologists, Technicians & Other Technical Service Providers |
| Other Name | Type Code |
|---|---|
| Siskiyou Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376893420 | Mccloud Healthcare Clinic, Inc. | Clinic/Center | 4309 Stagecoach Road, Dunsmuir, CA 96025 | 2012-09-17 |
| 1164428488 | Mccloud Healthcare Clinic, Inc. | Clinic/Center | 116 W Minnesota Ave, Mccloud, CA 96057-1143 | 2005-06-22 |
| 1033675582 | Mccloud Healthcare Clinic, Inc. | Clinic/Center | 824 Pine St, Mount Shasta, CA 96067-2137 | 2019-02-20 |
| Street Address |
828 PINE ST |
| City | MOUNT SHASTA |
| State | CA |
| Zip Code | 96067-2137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538786322 | Lynn Louise Lloyd | Acupuncturist | 522 E. Alma St, Mount Shasta, CA 96067 | 2020-06-29 |
| 1356971626 | Insight Wellness Institute | Clinic/Center | 1005 Ream Ave, Mount Shasta, CA 96067 | 2020-01-24 |
| 1720477052 | Mountain Medics Inc | Ambulance | 234 Gateway Park Drive, Mount Shasta, CA 96067 | 2015-01-09 |
| 1093120172 | Diana L Muncy | Counselor | 301 N Mount Shasta Blvd Ste 2, Mount Shasta, CA 96067 | 2014-06-26 |
| 1174851901 | Aaron Michael Stutz | Emergency Medicine | 234 Gateway Park Dr., Mount Shasta, CA 96067 | 2009-12-07 |
| 1487875415 | Blanchard Leroy Foster Jr. | Marriage & Family Therapist | 110 W. Castle Street, Suite 100, Mount Shasta, CA 96067 | 2007-05-01 |
| 1699815639 | Sally Mcfall | Marriage & Family Therapist | 1180-b Mount Shasta Blvd, Mt Shasta, CA 96067 | 2007-02-07 |
| 1174672174 | Anna Klimaszewski | Marriage & Family Therapist | 425 Oakway Rd, Mt Shasta, CA 96067 | 2007-01-09 |
| 1548355969 | John Cunningham | Marriage & Family Therapist | 705 Pine St., Mt Shasta, CA 96067 | 2006-10-03 |
| 1245330844 | Jacqueline Wilkinson Gilbert-parker | Physician Assistant | 822 Pine Street, Mount Shasta, CA 96067 | 2006-09-24 |
| Find all providers in zip 96067 | ||||
| Taxonomy Code | 2471B0102X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Bone Densitometry |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033614193 | Timothy S. Johnston, M.d. PC | Radiologic Technologist | 3349 G St Ste B, Merced, CA 95340-0978 | 2018-03-29 |
| 1114171675 | Soloutions & Insights | Radiologic Technologist | 34163 Pacific Coast Hwy, Suite 100, Dana Point, CA 92629-2848 | 2008-11-11 |
| 1801072301 | Cynthia Kingery | Radiologic Technologist | 3179 Alta Laguna Blvd, Laguna Beach, CA 92651-2061 | 2008-01-14 |
| 1801086616 | The Osteoporosis Medical Center | Radiologic Technologist | 8641 Wilshire Blvd Ste 301, Beverly Hills, CA 90211-2921 | 2007-07-27 |
| 1083725329 | Julie A Wade | Radiologic Technologist | 105 E Oberlin Rd, Yreka, CA 96097-9553 | 2006-08-31 |
| 1689668279 | Stephen William Kennedy | Radiologic Technologist | 9300 W Stockton Blvd, Ste 104, Elk Grove, CA 95758-8070 | 2005-09-09 |
| 1780090787 | Mobile Medical Examination Services Mso | Radiologic Technologist | 1241 E Dyer Rd Ste 145, Santa Ana, CA 92705-5694 | 2014-07-10 |
| 1003963299 | Osteoporosis Diagnostic Center | Radiologic Technologist | 2773 Harris St, Suite F, Eureka, CA 95503-4866 | 2007-01-03 |
| 1164584892 | Northern California Institute for Bone Health, Inc | Radiologic Technologist | 50 Vashell Way, Suite 400, Orinda, CA 94563 | 2006-12-16 |
| 1972671725 | Vanessa G Au | Radiologic Technologist | 350 30th St, #320, Oakland, CA 94609-3424 | 2006-12-01 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT SHASTA |
| Zip Code | 96067 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.