ENTERPRISE FAMILY HEALTH & DENTAL CENTER
NPI 1669004123
Clinic/Center - Federally Qualified Health Center (FQHC) in Redding, CA

Active since February 12, 2020CLIA 05D2290197 · Waiver
1201 INDUSTRIAL ST, REDDING, CA 96002(530) 246-5710 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 16, 2024, Feb 12, 2020 (2 updates tracked since 2020).

About Enterprise Family Health & Dental Center NPPES

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

ENTERPRISE FAMILY HEALTH & DENTAL CENTER (NPI 1669004123) is a healthcare organization registered as a federally qualified health center (fqhc) in Redding, California and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through September 22, 2027 and lists Jeffery Brandon Thornock, Ceo, as its authorized official.

NPPES Registry Identity

NPI1669004123
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSHASTA COMMUNITY HEALTH CENTER
Location Address1201 INDUSTRIAL STRedding, CA 96002-0757
Mailing AddressPo Box 992790Redding, CA 96099-2790 · (530) 246-5710
Organization SubpartNo
Authorized OfficialJeffery Brandon ThornockCeo · (530) 246-5074
Enumeration DateFebruary 12, 2020
Last NPPES UpdateOctober 16, 20242 updates tracked since enumeration
NPPES CertifiedOctober 16, 2024
✔ NPI 1669004123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedOptometristTaxonomy 152W00000X
Also ListedSpecialistTaxonomy 174400000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedOphthalmologyTaxonomy 207W00000X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
1201 INDUSTRIAL ST, Redding, CA 96002

Other Names 1

Doing Business AsEnterprise Family Health & Dental Center

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

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)

Enterprise Family Health & Dental 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.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20040629000721Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

143

Medicare enrollment records show 143 clinicians reassign Medicare billing to Enterprise Family Health & Dental Center, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 101 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Nurse Practitioner46
Family Practice44
Dentist8
Clinical Social Worker7
Marriage and Family Therapist5
Pediatric Medicine5
Chiropractic4
Psychiatry3
16 other specialties21

Nearest to this location (20)

See all 143
Nurse Practitioner
NPI 1891441531
1201 INDUSTRIAL ST
Redding, CA 96002
(530) 229-5000
✔ PECOS✔ Accepts MedicareSame address
Dentist
NPI 1942281746
1201 INDUSTRIAL ST
Redding, CA 96002
(530) 246-5700
✔ PECOS0.2 mi
Dentist
NPI 1760289581
1201 INDUSTRIAL ST
Redding, CA 96002
(530) 246-5700
✔ PECOS0.2 mi
Nurse Practitioner
NPI 1083567283
1201 INDUSTRIAL ST
Redding, CA 96002
(530) 246-5710
✔ PECOS✔ Accepts Medicare0.2 mi
Nurse Practitioner
NPI 1811138712
1147 HARTNELL AVE
Redding, CA 96002
(530) 222-7213
✔ PECOS✔ Accepts Medicare0.7 mi
Marriage and Family Therapist
NPI 1588277362
415 KNOLLCREST DR STE 101
Redding, CA 96002
(530) 392-4399
✔ PECOS0.8 mi
Chiropractic
NPI 1407157241
2335 ATHENS AVE
Redding, CA 96001
(530) 247-4228
1.4 mi
Podiatry
NPI 1659452399
2570 GOODWATER AVE SUITE 100
Redding, CA 96002
(530) 224-0990
✔ PECOS✔ Accepts Medicare1.4 mi
Clinical Social Worker
NPI 1003836982
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS✔ Accepts Medicare2.0 mi
Family Practice
NPI 1023225521
1035 PLACER STREET
Redding, CA 96001
(530) 246-5721
✔ PECOS✔ Accepts Medicare2.0 mi
Pediatric Medicine
NPI 1881735728
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS2.0 mi
Nurse Practitioner
NPI 1043332521
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS2.0 mi
Emergency Medicine
NPI 1407840895
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS2.0 mi
Marriage and Family Therapist
NPI 1598867459
1035 PLACER ST
Redding, CA 96001
(530) 229-5064
✔ PECOS✔ Accepts Medicare2.0 mi
Osteopathic Manipulative Medicine
NPI 1801477062
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS✔ Accepts Medicare2.0 mi
Psychiatry
NPI 1861514531
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS✔ Accepts Medicare2.0 mi
Obstetrics/Gynecology
NPI 1386670040
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ PECOS2.0 mi
Registered Dietitian or Nutrition Professional
NPI 1679381370
1035 PLACER ST
Redding, CA 96001
(530) 246-5710
✔ Accepts Medicare2.0 mi
Preventive Medicine
NPI 1619039716
1035 PLACER ST EIS
Redding, CA 96001
(530) 246-5764
✔ PECOS✔ Accepts Medicare2.0 mi
General Surgery
NPI 1003837543
1555 EAST ST SUITE 200
Redding, CA 96001
(530) 246-7400
✔ PECOS✔ Accepts Medicare2.1 mi
See all 143 clinicians

Source: 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 05D2290197

Enterprise Family Health And Dental Care · Redding, CA
Active · expires Sep 22, 2027
CLIA Number05D2290197
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 23, 2025
Certificate Expiration DateSeptember 22, 2027
Laboratory DirectorCollin W. Lynn
Laboratory Phone(530) 646-3932
Laboratory LocationEnterprise Family Health And Dental Care1201 Industrial Street, Redding, CA 96002
CLIA data matches this NPI record on: Address
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 Shasta Community Health Center's NPI number?

The NPI number for Shasta Community Health Center is 1669004123. It was assigned to this organization in the NPPES registry on February 12, 2020. The provider is doing business as Enterprise Family Health & Dental Center.

Where is Shasta Community Health Center located?

Shasta Community Health Center is located at 1201 Industrial St, Redding, CA 96002. 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, 1 practice at this address and 101 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 05D2290197) is associated with this NPI, valid through September 22, 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.