PRIME HEALTHCARE SERVICES, SHASTA LLC (NPI# 1134569650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134569650 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTHCARE SERVICES, SHASTA LLC |
| Other Organization Name | SHASTA REGIONAL MEDICAL CENTER |
| Practice Address |
1100 Butte St Redding CA 96001-0852 |
| Practice Telephone | 5302445454 |
| Mailing Telephone | 5302445454 |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2016-11-16 |
| Authorized Official Name | JOE HILL (MEDICARE SUPERVISOR) |
| Authorized Official Telephone | 5302424921 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIME HEALTHCARE SERVICES, SHASTA LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 230000023 | CA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 0177738 | 05 |
| Other Name | Type Code |
|---|---|
| Shasta Regional Medical Center | Former Legal Business Name - Organization |
| Street Address |
1100 BUTTE ST |
| City | REDDING |
| State | CA |
| Zip Code | 96001-0852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073580577 | Pavan K Davuluri | Anesthesiology | 1100 Butte St, Redding, CA 96001 | 2006-03-02 |
| 1487255816 | Jessica Ann Kandybe | Registered Nurse | 1100 Butte St, Redding, CA 96001-0852 | 2020-11-03 |
| 1306474135 | Tai Chinnock Moses | Physician Assistant | 1100 Butte St, Redding, CA 96001-0852 | 2020-03-28 |
| 1073150025 | Carl Evan Bennett | Nurse Practitioner | 1100 Butte St, Redding, CA 96001-0852 | 2019-12-09 |
| 1427604636 | Maria C Morales | Nurse Practitioner | 1100 Butte St, Redding, CA 96001-0852 | 2019-08-13 |
| 1962982165 | Eric Lee Svendsen | Physician Assistant | 1100 Butte St, Redding, CA 96001 | 2018-08-16 |
| 1174017214 | Far Northern Anesthesia Consultants | Anesthesiology | 1100 Butte St, Redding, CA 96001 | 2018-06-21 |
| 1629583018 | Clear Creek Medical Corp | Family Medicine | 1100 Butte St, Redding, CA 96001-0852 | 2017-12-06 |
| 1457879009 | Noah Chutz | Physician Assistant | 1100 Butte St, Redding, CA 96001 | 2017-09-05 |
| 1679007140 | Shasta Regional Emergency Medical Associates, Inc | Emergency Medicine | 1100 Butte St, Redding, CA 96001-0852 | 2017-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807643 | Pacific Health Group Inc. | Psychiatric Unit | 9120 Woodman Ave, Arleta, CA 91331-6405 | 2020-06-26 |
| 1720627979 | Ernest Markovich | Psychiatric Unit | 3235 N Hartman St, Orange, CA 92865-1216 | 2020-01-04 |
| 1316416670 | Psychiatric Excellence | Psychiatric Unit | 388 Market St Ste 1300, San Francisco, CA 94111-5316 | 2018-11-16 |
| 1982192514 | Veronica E Martinez | Psychiatric Unit | 9481 Hanford St, Ventura, CA 93004-0704 | 2018-04-30 |
| 1679008817 | Ucla Semel Institute | Psychiatric Unit | 615 6th St, Davis, CA 95616-3807 | 2017-04-25 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1871045385 | Molina Psychological Consultants | Psychiatric Unit | 18 Monrovia, Irvine, CA 92602-0925 | 2016-10-31 |
| 1457808073 | Susan Mora | Psychiatric Unit | 1239 Powell St, Apt 2, San Francisco, CA 94133-4874 | 2016-09-01 |
| 1306204342 | County of Santa Clara | Psychiatric Unit | 820 Enborg Court, San Jose, CA 95128 | 2016-02-05 |
| 1477931673 | Nigthingale Nurses | Psychiatric Unit | 350 N Magnolia St, Woodlake, CA 93286-1320 | 2015-05-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PRIME HEALTHCARE SERVICES, SHASTA LLC.
| 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.