NPIMap

Organization Active NPI

Barton Healthcare System

Doing business as Barton Memorial Hospital

  • General Acute Care Hospital
  • South Lake Tahoe, CA
National Provider Identifier
1003867565
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
030000013 Issued in CA
Legal business name
BARTON HEALTHCARE SYSTEM
Doing business as
Barton Memorial Hospital
Practice address
2170 South Ave
South Lake Tahoe, CA 96150-7026
Phone
(530) 541-3420
Fax
(530) 541-2512
NPI assigned
May 12, 2006
Last updated
Aug 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Authorized official

Name
Dr. Clinton D Purvance, MD
Title
President/Ceo
Phone
(530) 541-3420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 030000013 CA Primary

Addresses

Primary practice location

2170 South Ave
South Lake Tahoe, CA 96150-7026

Mailing address

PO Box 9578
South Lake Tahoe, CA 96158-9578
Phone (530) 541-3420

Other names 1

  • Barton Memorial Hospital Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL http://WWW.mettles.com/ Other
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040812001357 CA Part A Provider - Hospital 1850293960 Practice locations: S Lake Tahoe, CA
O20040915000806 CA Part B Supplier - Clinic/Group Practice 1850293960 Receives reassigned benefits from 118 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: South Lake Tahoe, CA; Twin Bridges, CA; Kirkwood, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003867565. Details of each certification follow.

Hospital certification: CCN 050352

Legal name
BARTON HEALTHCARE SYSTEM
Doing business as
BARTON MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 31, 2024
Beds
64
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 31, 1960 in CA
Enrollment address
2170 South Ave
S Lake Tahoe, CA 96150-7026
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Barton Memorial HospitalCCN 050352 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Abby Killebrew Individual Corporate Director May 22, 2014
Barton Healthcare System Organization, S Lake Tahoe, CA Non-profit 5% Or Greater Direct Ownership Interest Dec 2, 2005 100%
Kelly Neiger Individual Corporate OfficerCfo Nov 11, 2018
Operational/Managerial Control Nov 11, 2018
Clinton D Purvance Individual Corporate OfficerPresident/Ceo Nov 1, 2015
Operational/Managerial ControlPresident/Ceo Nov 1, 2015
Charles Scharer Individual Corporate Director May 26, 2005
Kirk Ledbetter Individual Corporate Director Jan 1, 2008

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Carson Valley HealthGardnerville, NV, CCN 291306 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2000
Carson Valley HealthGardnerville, NV, CCN 29Z306 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 2008
Barton Memorial HospitalSouth Lake Tahoe, CA, CCN 555698 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Mar 7, 1997
Apr 4, 1997
Mar 7, 1997
Barton Community Health CenterSouth Lake Tahoe, CA, CCN 058580 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2002
Aug 1, 2002
Carson Valley Health Primary Care Topaz RanchWellington, NV, CCN 293985 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2000

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 244

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 244

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1003867565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9578",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961589578",
            "telephone_number": "530-541-3420",
            "fax_number": "530-541-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3420",
            "fax_number": "530-541-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTON HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "PURVANCE",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "530-541-3420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "030000013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://WWW.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS EsMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Barton Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.