NPIMap

Organization Active NPI

Apla Health & Wellness

Doing business as APLA Health & Wellness - David Geffen Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1003230038
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550002233 Issued in CA
Legal business name
APLA HEALTH & WELLNESS
Doing business as
APLA Health & Wellness - David Geffen Center
Practice address
611 S Kingsley Dr
Los Angeles, CA 90005-2319
Phone
(213) 201-1623
Fax
(213) 201-1595
NPI assigned
Feb 11, 2014
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Craig E. Thompson
Title
Chief Executive Officer
Phone
(213) 201-1456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 550002233 CA Primary

Addresses

Primary practice location

611 S Kingsley Dr
Los Angeles, CA 90005-2319

Mailing address

611 S Kingsley Dr
Los Angeles, CA 90005-2319
Phone (213) 201-1623

Other names 1

  • APLA Health & Wellness - David Geffen Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140318002099 CA Part A Provider - Federally Qualified Health Center (FQHC) 4385875236 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003230038. Details of each certification follow.

Federally qualified health center certification: CCN 751061

Legal name
APLA HEALTH & WELLNESS
Doing business as
APLA HEALTH & WELLNESS - DAVID GEFFEN CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 26, 2014
Last certification
Mar 26, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 16, 2004 in CA
Enrollment address
611 S Kingsley Dr
Los Angeles, CA 90005-2319

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Apla Health Wellness12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEIECA

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lee Klosinski Individual Corporate OfficerBoard Chair Oct 22, 2013
Corporate DirectorBoard Member Oct 22, 2013
Devin Martinez Individual Corporate Director Aug 28, 2024
Jessie McGrath Individual Corporate OfficerBoard Vice Chair Jan 27, 2017
Corporate DirectorBoard Member Jan 27, 2017
Cody Sisco Individual Corporate DirectorBoard Member Jun 26, 2019
Daphne Kay Redding Individual Corporate OfficerSecretary Jun 26, 2024
Corporate Director Jun 28, 2023
Joseph Moldovan Individual Corporate OfficerChief Financial Officer Aug 1, 2024
W-2 Managing EmployeeAd; Jan 9, 2023
Christopher Tang Individual Corporate DirectorBoard Member Jun 30, 2021
John Squatritto Individual Corporate DirectorBoard Member Jun 26, 2019
Craig E Thompson Individual Corporate OfficerChief Executive Officer Feb 14, 2014
Raul Rios Individual Corporate Director Aug 28, 2024
Apla Health & Wellness Organization, Los Angeles, CA Non-profit Other Oct 9, 2012 100%
Jay E Gladstein Individual W-2 Managing EmployeeChief Medical Officer Dec 1, 2017
Stuart Downey Individual Corporate Director Jun 28, 2023
Andrew Clark Individual Corporate Director Jun 28, 2023
Chad Franks Individual Corporate DirectorBoard Member Jun 26, 2019
Elwood Sides Individual Corporate Director Jun 28, 2023
Christine Cowan Individual Corporate Director Aug 28, 2024
David Flores Individual Corporate Director Jun 28, 2023
James Patton Individual Corporate Director Dec 2, 2023
Maricela de Rivera Individual Corporate DirectorBoard Member Jun 30, 2021
Lindsey Morrison Individual Corporate DirectorBoard Member Jun 30, 2021
John Sealy Individual Corporate DirectorBoard Member Jun 26, 2019
Natalia Ramos Individual Corporate DirectorBoard Member Jun 26, 2019
David Doan Individual Corporate Director Jun 28, 2023
M'Alyssa Mecenas Individual Corporate DirectorBoard Member Jun 24, 2020
Denis Cagna Individual Corporate OfficerTreasurer Jun 26, 2024
Corporate Director Jun 28, 2023

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Apla Health - Olympic #310Los Angeles, CA, CCN 921032 Federally qualified health center Other Oct 22, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1003230038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052319",
            "telephone_number": "213-201-1623",
            "fax_number": "213-201-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900052319",
            "telephone_number": "213-201-1623",
            "fax_number": "213-201-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APLA HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "213-201-1456",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550002233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "APLA Health & Wellness - David Geffen Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.