SHASTA REGIONAL EMERGENCY MEDICAL ASSOCIATES, INC (NPI# 1679007140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679007140 |
Entity Type | Organization |
Organization Name | SHASTA REGIONAL EMERGENCY MEDICAL ASSOCIATES, INC |
Practice Address |
1100 Butte St Redding CA 96001-0852 |
Mailing Address |
111 N Sepulveda Blvd Ste 210 Manhattan Beach CA 90266-6861 |
Practice Telephone | 5302445400 |
Mailing Telephone | 3106985474 |
Mailing Fax Number | 3103794856 |
Enumeration Date | 2017-04-12 |
Last Update Date | 2017-04-12 |
Authorized Official Name | IRV E EDWARDS (CEO) |
Authorized Official Telephone | 3106985474 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
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 |
1285185397 | Zachary Periharos | Physician Assistant | 1100 Butte St, Redding, CA 96001-0852 | 2016-10-24 |
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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 |
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Taxonomy Code | 207P00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Emergency Medicine |
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649554155 | Barry Roy Klein | Emergency Medicine | 16325 Canto De Las Lupine Dr, Redding, CA 96001-4399 | 2011-10-03 |
1720143530 | Teri Ann Boster | Emergency Medicine | 2175 Rosaline Ave., Medical Staff Office, Redding, CA 96049-6009 | 2006-12-22 |
1588778815 | Joanna Krystyna Ramseyer | Emergency Medicine | 8058 Placer View Ct, Redding, CA 96001-9577 | 2006-08-17 |
1497869648 | Andrew L. Knapp | Emergency Medicine | 2770 Eureka Way, Suite 100, Physicians Wound Center, Redding, CA 96001 | 2006-08-17 |
1295760056 | William Dykes | Emergency Medicine | 12450 Maria Drive, Redding, CA 96003 | 2006-07-11 |
1285096594 | Avigile Baehr | Emergency Medicine | 1100 Butte St, Redding, CA 96001-0852 | 2016-03-25 |
1811308190 | Charles Everett Mansell | Emergency Medicine | 2175 Rosaline Ave, Redding, CA 96001-2549 | 2014-05-08 |
1215357264 | Ryan Meller | Emergency Medicine | 2175 Rosaline Ave, Redding, CA 96001-2549 | 2014-04-17 |
1033464656 | Paul Matthew Johnson | Emergency Medicine | 2175 Rosaline Ave, Redding, CA 96001-2509 | 2012-07-19 |
1700161064 | Travis Frederick Mackenzie | Emergency Medicine | 3335 Placer St, Pmb #212, Redding, CA 96001-2364 | 2011-10-19 |
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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.