SISKIYOU HOSPITAL, INC. (NPI# 1952701369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952701369 |
| Entity Type | Organization |
| Organization Name | SISKIYOU HOSPITAL, INC. |
| Other Organization Name | FAIRCHILD MEDICAL CENTER |
| Practice Address |
444 Bruce St Yreka CA 96097-3450 |
| Practice Telephone | 5308424121 |
| Mailing Telephone | 5308424121 |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |
| Authorized Official Name | MR. JONATHON ANDRUS (CEO) |
| Authorized Official Telephone | 5308416200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
230000035 | CA | Hospitals |
| Other Name | Type Code |
|---|---|
| Fairchild Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093892275 | Siskiyou Hospital, Inc. | Clinic/Center | 444 Bruce St, Yreka, CA 96097-3450 | 2006-11-01 |
| Street Address |
444 BRUCE ST |
| City | YREKA |
| State | CA |
| Zip Code | 96097-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043213549 | Dan C Purtzer | Pathology | 444 Bruce St, Yreka, CA 96097-3450 | 2005-05-27 |
| 1710530696 | Nina Yaftali | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2019-07-19 |
| 1467011627 | Saiba Hospitalist Associates | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2019-06-11 |
| 1922577535 | Marble Mountain Anesthesia, Inc., A Professional Nursing Corporation | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2018-11-14 |
| 1205335072 | Kim Marie Keller | Registered Nurse | 444 Bruce St, Yreka, CA 96097-3450 | 2018-02-07 |
| 1558873786 | Samuel C Birkholz | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2017-10-27 |
| 1710334677 | Nepomuceno Hospital Group Inc | Family Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2016-05-20 |
| 1265889562 | Mount Shasta Physicians Inc | Specialist | 444 Bruce St, Yreka, CA 96097-3450 | 2016-05-17 |
| 1093198764 | Premier Health Services Inc | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2015-06-30 |
| 1336537174 | Cameron Thomas Lovinger | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2015-01-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376830653 | Paul William Willis | Pharmacist | 807 S. Main St., Yreka, CA 96097 | 2011-07-07 |
| 1578883864 | Ginger A Bert | Chiropractor | 106 Ranch Ln Ste A, Yreka, CA 96097 | 2010-06-09 |
| 1669796611 | Rebekah Joyce Retterath | Dietitian, Registered | 444 Bruce Street, Yreka, CA 96097 | 2010-03-19 |
| 1780849679 | Donna Jean May | Marriage & Family Therapist | 625 Butte Street, Yreka, CA 96097 | 2008-07-21 |
| 1114121589 | Loren Cronk | Marriage & Family Therapist | 208 4th Street, Yreka, CA 96097 | 2007-06-12 |
| 1093928863 | Kristin Rene Kopplin | Psychologist | 1515 South Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-08 |
| 1073735379 | Rivkah Lynn Barmore | Social Worker | 1515 S Oregon, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1649492091 | Randy Terry Murieen | Social Worker | 1515 S Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1265654537 | Roy Victor Hall Jr. | Social Worker | 1515 South Oregon St, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1578785614 | Meadowlark | Assisted Living Facility | 351 Bruce St, Yreka, CA 96097 | 2007-05-02 |
| Find all providers in zip 96097 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
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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.