MENDOCINO COAST HEALTH CARE DISTRICT (NPI# 1538113725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538113725 |
| Entity Type | Organization |
| Organization Name | MENDOCINO COAST HEALTH CARE DISTRICT |
| Other Organization Name | MENDOCINO COAST DISTRICT HOSPITAL |
| Practice Address |
700 River Dr Fort Bragg CA 95437-5403 |
| Practice Telephone | 7079611234 |
| Practice Fax Number | 7079614901 |
| Mailing Telephone | 7079611234 |
| Mailing Fax Number | 7079614901 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-10 |
| Authorized Official Name | JASON WELLS (PRESIDENT) |
| Authorized Official Telephone | 7074563010 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
110000040 | CA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICAL OUTPATIENT | HSP40569F | 01 | |
| BLUE SHIELD | PHB160620 | 01 | |
| CA | BLUE SHIELD | ZZZ39861Z | 01 |
| CA | BLUE SHIELD ER | ZZZ96931Z | 01 |
| CA | BLUE SHIELD INFUSION | ZZZ36026Z | 01 |
| CA | BLUE SHIELD CLINIC | ZZZ57360Z | 01 |
| BLUE CROSS | 050569 | 01 | |
| CA | ZZR00569F | 05 | |
| CA | BLUE SHIELD | ZZZ14750Z | 01 |
| CA | BLUE SHIELD HOSPITAL | ZZZA2301Z | 01 |
| MEDICAL AMBULANCE | MTE00312F | 01 | |
| MEDICAL SWING BED | LTC30569F | 01 | |
| MEDICAL PHARMACY | PHB160620 | 01 |
| Other Name | Type Code |
|---|---|
| Mendocino Coast District Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124220249 | Mendocino Coast Health Care District | Clinic/Center | 721 River Drive, Suite A, Fort Bragg, CA 95437 | 2007-06-01 |
| 1710932157 | Mendocino Coast Health Care District | Home Health | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-24 |
| Street Address |
700 RIVER DR |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306896428 | John A Kermen | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1710336300 | Glass Beach Medical Services A Medical Corporation | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2016-06-06 |
| 1447585245 | Mark David Levine Md, Fort Bragg Professional Corporation | Psychiatry & Neurology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2009-10-12 |
| 1962666313 | Donald Sheffel, M.d. | Surgery | 700 River Dr, Fort Bragg, CA 95437-5403 | 2008-07-15 |
| 1891982351 | Lois Faith Leister | Pharmacist | 700 River Dr, Mendocino Coast District Hospital Pharmacy, Fort Bragg, CA 95437-5403 | 2007-09-28 |
| 1659562742 | Marilyn Magoffin | Nurse Practitioner | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-08-05 |
| 1255540340 | Phillip Conwell | Registered Nurse | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-05-22 |
| 1013060516 | Stephen Pinsk, M.d., Inc. | Clinical Medical Laboratory | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-01-19 |
| 1912079294 | Prakash P Devaskar | Pediatrics | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-11-14 |
| 1477641686 | Tamaki A. Myers | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619046695 | Womack Army Medical Center | General Acute Care Hospital | 2817 Reilly Road Mcxc-cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407208713 | Moheb Youssef,m.d.,inc | General Acute Care Hospital | 5730 Glen Oaks Dr, La Verne, CA 91750-1713 | 2016-07-11 |
| 1659720373 | Pavel S. Volkov, M.d. Inc. | General Acute Care Hospital | 2393 E Strathmore Pl, Fresno, CA 93730-9717 | 2016-06-03 |
| 1841647575 | Ma Corazon Sabado Domine-flores | General Acute Care Hospital | 13884 Euclid St Apt B01, Garden Grove, CA 92843-3401 | 2016-05-23 |
| 1215305404 | Karen Samartan | General Acute Care Hospital | 6361 Varsity Dr, Huntington Beach, CA 92647-6544 | 2015-09-04 |
| 1427486802 | Lake Arrowhead Physical Therapy | General Acute Care Hospital | 29099 Hospital Rd Suite 106, Lake Arrowhead, CA 92352-0070 | 2013-10-23 |
| 1841626587 | Adventist Health Clearlake Hospital, Inc | General Acute Care Hospital | 9430 Lake St, Lower Lake, CA 95457-8600 | 2013-09-25 |
| 1982948030 | Kern Medical Center | General Acute Care Hospital | 1420 H Street, Bakersfield, CA 93305 | 2012-11-15 |
| 1881960698 | Lisa M Bach Bohler | General Acute Care Hospital | 2202 N Magnolia Rd, Palm Springs, CA 92262-3652 | 2012-03-26 |
| 1750680914 | Cedars-sinai Medical Center | General Acute Care Hospital | 1650 Manning Ave, Los Angeles, CA 90024-5810 | 2011-03-26 |
| 1962705772 | Needles Hospital, Inc | General Acute Care Hospital | 1916 Desoto St, Needles, CA 92363-3023 | 2010-12-16 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
Please comment or provide details below to improve the information on MENDOCINO COAST HEALTH CARE DISTRICT.
| 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.