GOLD COUNTRY HEALTH INITIATIVE, LLC (NPI# 1932666575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932666575 |
| Entity Type | Organization |
| Organization Name | GOLD COUNTRY HEALTH INITIATIVE, LLC |
| Practice Address |
820/830 State Highway 88 Jackson CA 95642 |
| Mailing Address |
Po Box 4057 Stockton CA 95204-0057 |
| Practice Telephone | 2096101524 |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-12-06 |
| Authorized Official Name | ERNEST VASTI (OWNER) |
| Authorized Official Telephone | 2096101524 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 830 State Highway 88, Jackson, CA 95642 | 2096101524 |
| Street Address |
820/830 STATE HIGHWAY 88 |
| City | JACKSON |
| State | CA |
| Zip Code | 95642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| 1326539115 | Jessica Anne Mccarthy | Nurse Practitioner | 815 Court St Ste 7, Jackson, CA 95642 | 2018-05-29 |
| Find all providers in zip 95642 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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| 1669697801 | William Lelon Aron Jr. | Family Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2007-04-14 |
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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.