NORTHCOUNTRY CLINIC – NPI #1689778813
Clinic/Center

NORTHCOUNTRY CLINIC is an AHC clinic located in ARCATA, CA. NPPES has assigned the NPI number 1689778813 to NORTHCOUNTRY CLINIC on September 08, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “NORTHCOUNTRY CLINIC” is a dba name, the actual legal business name for this organization is OPEN DOOR COMMUNITY HEALTH CENTERS. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 3 years ago on Jun 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHCOUNTRY CLINIC below.

NPI Profile for
OPEN DOOR COMMUNITY HEALTH CENTERS

NPI Number
1689778813
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OPEN DOOR COMMUNITY HEALTH CENTERS
Doing Business As (dba): NORTHCOUNTRY CLINIC
Primary location
785 18TH STREET
ARCATA, CA 95521
Phone: (707) 822-2481 Fax: (707) 822-3656
Mailing address
1275 8TH ST
ARCATA, CA 95521-5770
Phone: (707) 826-8633 Fax: (707) 826-8638
Organization Subpart
No
Authorized Official
VICTOR STARR
PRESIDENT/ CEO
Phone: (707) 826-8633
Updated
Certification Date
Jun 07, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTHCOUNTRY CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidCAFHC03890G
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.