MERCY LAKE SHASTINA COMMUNITY CLINIC
NPI 1255609699
Clinic/Center - Rural Health in Weed, CA

NPI Status: Active since December 13, 2011

Contact Information

16337 EVERHART DR
WEED, CA
ZIP 96094
Phone: (530) 938-2297
Fax: (530) 938-0494

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  • Organization
  • Clinic/Center
  • Rural Health
  • CLIA Number: 05D2039442
  • CLIA Cert. Type: Community Clinic
  • CLIA Exp. Date: 06-29-2027

About MERCY LAKE SHASTINA COMMUNITY CLINIC

This page provides the complete NPI Profile along with additional information for Mercy Lake Shastina Community Clinic, a primary care provider established in Weed, California operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1255609699 assigned on December 2011. The practitioner's primary taxonomy code is 261QR1300X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Mercy Lake Shastina Community Clinic. The authorized official of this NPI record is Kim Miranda (Chief Financial Officer)

NPI
1255609699
Provider Legal Name
DIGNITY HEALTH
Other Organization Name
MERCY LAKE SHASTINA COMMUNITY CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
16337 EVERHART DR WEED, CA 96094
Location Phone
(530) 938-2297
Location Fax
(530) 938-0494
Mailing Address
3400 DATA DR 1ST FLOOR RANCHO CORDOVA, CA 95670
Mailing Phone
(530) 225-6300
Mailing Fax
(530) 938-0494
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-13-2011
Last Update Date
10-31-2016
Code Navigator

A primary care provider (PCP) like Mercy Lake Shastina Community Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rural Health

Taxonomy Code
261QR1300X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIM MIRANDA

Authorized Official Title
CHIEF FINANCIAL OFFICER
Authorized Official Phone
(530) 225-6121

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
473431860OTHER (01)SP TIN
058662MEDICARE OSCAR/CERTIFICATION (06)CA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D2039442
Facility Type
Community Clinic
Certificate Effective Date
June 30, 2025
Certificate Expiration Date
June 29, 2027
Laboratory Director
MATTHEW J. KILPATRICK
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mercy Lake Shastina Community Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for MERCY LAKE SHASTINA COMMUNITY CLINIC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1255609699, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
5
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
0
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 6 → 12 → 3 9 → 18 → 9 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 0 + 5 + 1 + 2 + 0 + 1 + 8 + 6 + 1 + 8 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1255609699.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Family Medicine
16337 EVERHART DR
WEED, CA 96094
Family Medicine
16337 EVERHART DR
WEED, CA 96094
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Physician Assistant
16337 EVERHART DR
WEED, CA 96094

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255609699, enumerated as an "organization" on December 13, 2011.

The provider is located at 16337 EVERHART DR WEED, CA 96094 and the phone number is (530) 938-2297.

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.