Healthcare Provider Details
I. General information
NPI: 1619864626
Provider Name (Legal Business Name): RURAL MEDICINE DIRECT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20530 BIG SPRINGS RD STE 3
WEED CA
96094-9600
US
IV. Provider business mailing address
20530 BIG SPRINGS RD STE 3
WEED CA
96094-9600
US
V. Phone/Fax
- Phone: 541-646-4088
- Fax: 541-290-1290
- Phone: 541-646-4088
- Fax: 541-290-1290
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QE0002X |
| Taxonomy | Emergency Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
ANNE
SHEALY
Title or Position: PRESIDENT
Credential: NP
Phone: 541-646-4088