PINE STREET CLINIC
NPI 1942632534
Clinic/Center - Rural Health in Mount Shasta, CA
NPI Status: Active since August 06, 2013
Contact Information
408 PINE ST
MOUNT SHASTA, CA
ZIP 96067
Phone: (530) 926-6111
Fax: (530) 926-0517
- Organization
- Clinic/Center
- Rural Health
- CLIA Number: 05D2069763
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 06-04-2028
About PINE STREET CLINIC
This page provides the complete NPI Profile along with additional information for Pine Street Clinic, a primary care provider established in Mount Shasta, California operating as a Clinic/center, focusing in rural health . The healthcare provider is registered in the NPI registry with number 1942632534 assigned on August 2013. 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 Pine Street Clinic. The authorized official of this NPI record is Kim Miranda (Chief Financial Officer)
- NPI
- 1942632534
- Provider Legal Name
- DIGNITY HEALTH
- Other Organization Name
- PINE STREET CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 408 PINE ST MOUNT SHASTA, CA 96067
- Location Phone
- (530) 926-6111
- Location Fax
- (530) 926-0517
- Mailing Address
- 3400 DATA DR 1ST FLOOR RANCHO CORDOVA, CA 95670
- Mailing Phone
- (530) 225-6300
- Mailing Fax
- (530) 926-0517
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 08-06-2013
- Last Update Date
- 10-31-2016
- Code Navigator
A primary care provider (PCP) like Pine Street 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.
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 |
|---|---|---|---|
| 058674 | MEDICARE OSCAR/CERTIFICATION (06) | CA | |
| 473431860 | OTHER (01) | SP TIN |
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
- 05D2069763
- Facility Type
- Community Clinic
- Certificate Effective Date
- June 05, 2026
- Certificate Expiration Date
- June 04, 2028
- Laboratory Director
- MATTHEW J. KILPATRICK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Pine Street 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.
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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 1942632534, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942632534, enumerated as an "organization" on August 06, 2013.
The provider is located at 408 PINE ST MOUNT SHASTA, CA 96067 and the phone number is (530) 926-6111.
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.
