SHASTA COMMUNITY TELEMEDICINE AND TRAINING CENTER
NPI 1114533171
Clinic/Center - Federally Qualified Health Center (FQHC) in Redding, CA
About Shasta Community Telemedicine And Training Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHASTA COMMUNITY TELEMEDICINE AND TRAINING CENTER (NPI 1114533171) is a healthcare organization registered as a federally qualified health center (fqhc) in Redding, California and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through July 9, 2027 and lists Jeffery Brandon Thornock, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shasta Community Telemedicine And Training Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
143Medicare enrollment records show 143 clinicians reassign Medicare billing to Shasta Community Telemedicine And Training Center, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 98 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 24
Nearest to this location (20)
See all 143Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 05D0618142
Shasta Community Health Center · Redding, CAFrequently 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 Shasta Community Health Center's NPI number?
The NPI number for Shasta Community Health Center is 1114533171. It was assigned to this organization in the NPPES registry on September 16, 2020. The provider is doing business as Shasta Community Telemedicine And Training Center.
Where is Shasta Community Health Center located?
Shasta Community Health Center is located at 1756 Continental St, Redding, CA 96001. The listed phone number is (530) 246-5710.
What is Shasta Community Health Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Shasta Community Health Center enrolled in Medicare?
Yes. Shasta Community Health Center is registered in the Medicare PECOS enrollment system.
When is Shasta Community Health Center's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Shasta Community Health Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 143 clinicians in 24 Medicare specialties reassign their Medicare billing to Shasta Community Health Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (46), Family Practice (44) and Dentist (8). Of these, 6 practice at this address and 98 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shasta Community Health Center hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0618142) is associated with this NPI, valid through July 9, 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 Shasta Community Health Center was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Shasta Community Telemedicine And Training Center · NPI 1114533171
Federally Qualified Health Center (FQHC) organization in Redding, California. Organization record, active in the CMS NPPES registry since September 16, 2020.
## Identity
- **NPI:** 1114533171 (Entity type: Organization)
- **Enumerated:** September 16, 2020
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Shasta Community Health Center
- **Organization subpart:** No
- **Authorized official:** Jeffery Thornock, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 1756 CONTINENTAL ST, Redding, CA 96001-1240
- **Phone:** (530) 246-5710
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 143 clinicians in 24 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (46), Family Practice (44), Dentist (8); 6 practice at this address and 98 within 10 miles; [full list](https://npiprofile.com/npi/1114533171/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 16, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114533171) · Data from the CMS NPPES public registry.