MCCLOUD HEALTHCARE CLINIC, INC.
NPI 1003372624
Radiologic Technologist - Bone Densitometry in Mount Shasta, CA

Q: What is Mccloud Healthcare Clinic, Inc.'s NPI number?

The NPI number for Mccloud Healthcare Clinic, Inc. is 1003372624. It was assigned to this organization in the NPPES registry on February 19, 2019. The provider is doing business as Siskiyou Medical Group.

Q: What is Mccloud Healthcare Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Radiologic Technologist, specializing in Bone Densitometry, with taxonomy code 2471B0102X.

Active since February 19, 2019CLIA 05D0981317 · Microscopy

828 PINE ST, MOUNT SHASTA, CA 96067(530) 926-4528 Get Directions Write a Review

NPPES record last updated: February 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mccloud Healthcare Clinic, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MCCLOUD HEALTHCARE CLINIC, INC. (NPI 1003372624), doing business as Siskiyou Medical Group, is a healthcare organization registered as a bone densitometry in Mount Shasta, California and active in the NPI registry since February 2019. The organization holds a CLIA Microscopy certificate valid through March 18, 2027 and lists James Proffitt, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003372624

Entity TypeOrganization

Primary Taxonomy2471B0102X

Legal Business NameMCCLOUD HEALTHCARE CLINIC, INC.

Location Address828 PINE STMount Shasta, CA 96067-2137

Mailing AddressPo Box 1143Mccloud, CA 96057-1143 · (530) 964-2389

Phone(530) 926-4528

Organization SubpartYes

Authorized OfficialJames ProffittCeo · (530) 964-2389

Enumeration DateFebruary 19, 2019

✔ NPI 1003372624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiologic Technologist · Bone DensitometryTechnologists, Technicians & Other Technical Service Providers

Taxonomy Code2471B0102X

Definition

A radiologic technologist who specializes in bone densitometry and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy, in performance of bone density imaging, exam techniques, equipment protocols, radiation safety, and patient care.

828 PINE ST, Mount Shasta, CA 96067

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Other Names 1

Doing Business AsSiskiyou Medical Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0981317

Mccloud Healthcare Clinic Inc · Mccloud, CA

Active · expires Mar 18, 2027

CLIA Number05D0981317

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateMarch 19, 2025

Certificate Expiration DateMarch 18, 2027

Laboratory DirectorGrady Fort

Laboratory Phone(530) 964-2389

Laboratory LocationMccloud Healthcare Clinic Inc116 W Minnesota Ave, Mccloud, CA 96057

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mccloud Healthcare Clinic, Inc.'s NPI number?

The NPI number for Mccloud Healthcare Clinic, Inc. is 1003372624. It was assigned to this organization in the NPPES registry on February 19, 2019. The provider is doing business as Siskiyou Medical Group.

Where is Mccloud Healthcare Clinic, Inc. located?

Mccloud Healthcare Clinic, Inc. is located at 828 Pine St, Mount Shasta, CA 96067. The listed phone number is (530) 926-4528.

What is Mccloud Healthcare Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Radiologic Technologist, specializing in Bone Densitometry, with taxonomy code 2471B0102X.

Does Mccloud Healthcare Clinic, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0981317) is associated with this NPI, valid through March 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mccloud Healthcare Clinic, Inc. was last updated on February 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.