ANDERSON VALLEY HEALTH CENTER (NPI# 1568449304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568449304 |
| Entity Type | Organization |
| Organization Name | ANDERSON VALLEY HEALTH CENTER |
| Practice Address |
13500 Airport Road Boonville CA 95415 |
| Mailing Address |
Po Box 338 Boonville CA 95415-0338 |
| Practice Telephone | 7078953477 |
| Practice Fax Number | 7078952035 |
| Mailing Telephone | 7078953477 |
| Mailing Fax Number | 7078952035 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-07-25 |
| Authorized Official Name | SUSAN D SMITH (CEO) |
| Authorized Official Telephone | 7078953477 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
110000165 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 051024 | 05 | |
| CA | FHC03881F | 05 |
| Street Address |
13500 AIRPORT ROAD |
| City | BOONVILLE |
| State | CA |
| Zip Code | 95415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316130792 | Cynthia S Arbanovella | Clinical Nurse Specialist | 13500 Airport Road, Boonville, CA 95415 | 2007-08-20 |
| 1538219779 | Mark Justin Apfel | Family Medicine | 13500 Airport Road, Boonville, CA 95415 | 2007-01-11 |
| 1689724007 | Peter H. Barg | Family Medicine | 13500 Airport Road, Boonville, CA 95415 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881132843 | Anderson Valley Community Services District | Ambulance | 14281 Hwy 128, Boonville, CA 95415 | 2017-02-09 |
| 1255471595 | Susan J Bridge-mount | Marriage & Family Therapist | 18151 Mountain View Road, Boonville, CA 95415 | 2007-02-07 |
| 1871039479 | Vintage Vinetours LLC | Non-emergency Medical Transport (VAN) | 14361 Hwy 128, Box 236, Boonville, CA 95415 | 2017-01-06 |
| 1841734373 | William Housley | Driver | 14361 Hwy 128, 236, Boonville, CA 95415-0236 | 2016-12-19 |
| 1881771889 | Carole Ann Murphy | Dentist | 13500 Airport Rd, Boonville, CA 95415-9133 | 2006-11-01 |
| 1750891321 | Stephanie Shreve | Psychologist | 13500 Airport Rd, Boonville, CA 95415-9133 | 2017-10-09 |
| 1982123170 | Luiza M Savin | Nurse Practitioner | 13500 Airport Rd, Boonville, CA 95415-9133 | 2017-09-19 |
| 1225260623 | Pon T Tath | Dentist | 13500 Airport Rd, Boonville, CA 95415-9133 | 2009-08-18 |
| 1780723981 | Toni Marie Mann | Dentist | 13500 Airport Rd, Boonville, CA 95415-9133 | 2007-02-05 |
| 1326194317 | Anderson Valley Ambulance Service | Ambulance | 13500 Airport Rd, Boonville, CA 95415-9133 | 2007-01-25 |
| Find all providers in zip 95415 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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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.