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WARNER MOUNTAIN INDIAN HEALTH PROJECT
NPI 1093931107
Clinic/Center - Rural Health in Fort Bidwell, CA

Active since April 17, 2007CLIA 05D0692143 · Waiver
132 MEE THEE UH ROAD, FORT BIDWELL, CA 96112(530) 279-6194(530) 279-6288 Get Directions Write a Review

NPPES record last updated: July 2, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Warner Mountain Indian Health Project NPPES

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

WARNER MOUNTAIN INDIAN HEALTH PROJECT (NPI 1093931107) is a healthcare organization registered as a rural health in Fort Bidwell, California and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Candice Dawn Russell, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1093931107
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameFORT BIDWELL INDIAN COMMUNITY
Location Address132 MEE THEE UH ROADFort Bidwell, CA 96112
Mailing AddressPo Box 247Fort Bidwell, CA 96112-0247 · (530) 279-6194 · Fax (530) 279-6288
Phone(530) 279-6194
Fax(530) 279-6288
Organization SubpartNo
Authorized OfficialCandice Dawn RussellClinic Manager · (530) 279-6194
Enumeration DateApril 17, 2007
Last NPPES UpdateJuly 2, 2008
✔ NPI 1093931107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
132 MEE THEE UH ROAD, Fort Bidwell, CA 96112
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Other Names 1

Other NameWarner Mountain Indian Health Project

Other Identifiers 3

MedicaidTHP70973FCA
Medicare ID-Type UnspecifiedZZZ270012ZCA · Medicare
OtherO5D0692143CA · Clia

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 of Waiver 05D0692143

Warner Mountain Indian Health Clinic · Fort Bidwell, CA
Active · expires Aug 31, 2026
CLIA Number05D0692143
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMark C. Goodman MD
Laboratory Phone(530) 279-6194
Laboratory LocationWarner Mountain Indian Health Clinic132 Mee Thee-Uh Road, Fort Bidwell, CA 96112
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only 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 Fort Bidwell Indian Community's NPI number?

The NPI number for Fort Bidwell Indian Community is 1093931107. It was assigned to this organization in the NPPES registry on April 17, 2007. The provider is also known as Warner Mountain Indian Health Project.

Where is Fort Bidwell Indian Community located?

Fort Bidwell Indian Community is located at 132 Mee Thee Uh Road, Fort Bidwell, CA 96112. The listed phone number is (530) 279-6194.

What is Fort Bidwell Indian Community's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Fort Bidwell Indian Community hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0692143) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fort Bidwell Indian Community was last updated on July 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.