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LAKE SHASTINA MEDICAL CLINIC INC
NPI 1356331615
Family Medicine in Weed, CA

Active since October 26, 2005
16337 EVERHART DR, WEED, CA 96094(530) 938-2297(530) 938-0494 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Lake Shastina Medical Clinic Inc NPPES

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

LAKE SHASTINA MEDICAL CLINIC INC (NPI 1356331615) is a healthcare organization registered as a family medicine in Weed, California and active in the NPI registry since October 2005. The organization lists Phillip M Miller, Ceo, as its authorized official.

NPPES Registry Identity

NPI1356331615
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE SHASTINA MEDICAL CLINIC INC
Location Address16337 EVERHART DRWeed, CA 96094-9400
Mailing Address16337 Everhart DrWeed, CA 96094-9400 · (530) 938-2297 · Fax (530) 938-0494
Phone(530) 938-2297
Fax(530) 938-0494
Organization SubpartNo
Authorized OfficialPhillip M MillerCeo · (530) 938-2297
Enumeration DateOctober 26, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1356331615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
16337 EVERHART DR, Weed, CA 96094
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Other Identifiers 1

MedicaidGR0098510CA

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

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIGNITY HEALTH
Clinic/Center (Rural Health)
16337 EVERHART DR
WEED, CA 96094
Siskiyou County (530) 938-2297
MR. JEFFREY ALEXANDER OTT F.N.P.
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Siskiyou County (530) 938-2297
DEBRA LYNNE GORDON FNP-C
Nurse Practitioner (Family)
16337 EVERHART DR
WEED, CA 96094
Siskiyou County (530) 938-2297
KRISTIN MERCIER PA
Physician Assistant
16337 EVERHART DR
WEED, CA 96094
Siskiyou County (530) 938-2297
DR. JILL C MILLER M.D.
Family Medicine
16337 EVERHART DR
WEED, CA 96094
Siskiyou County (530) 938-2297

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 Lake Shastina Medical Clinic Inc's NPI number?

The NPI number for Lake Shastina Medical Clinic Inc is 1356331615. It was assigned to this organization in the NPPES registry on October 26, 2005.

Where is Lake Shastina Medical Clinic Inc located?

Lake Shastina Medical Clinic Inc is located at 16337 Everhart Dr, Weed, CA 96094. The listed phone number is (530) 938-2297.

What is Lake Shastina Medical Clinic Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Lake Shastina Medical Clinic Inc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.