NPIMap

Organization Active NPI

Grossmont Hospital Corporation

Doing business as Sharp Grossmont Hospital Rehab

  • Rehabilitation Hospital Unit
  • La Mesa, CA
National Provider Identifier
1043293871
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
080000006 Issued in CA
Legal business name
GROSSMONT HOSPITAL CORPORATION
Doing business as
Sharp Grossmont Hospital Rehab
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 740-6000
NPI assigned
Nov 25, 2005
Last updated
Mar 4, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
GROSSMONT HOSPITAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Authorized official

Name
Scott Evans
Title
Ceo
Phone
(619) 740-4648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 080000006 CA Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

8695 Spectrum Center Blvd
San Diego, CA 92123-1489
Phone (858) 499-3025

Other names 1

  • Sharp Grossmont Hospital Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000675 CA Part A Provider - Hospital 4183518137 Practice locations: La Mesa, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043293871. Details of each certification follow.

Hospital certification: CCN 05T026

Legal name
GROSSMONT HOSPITAL CORPORATION
Organization structure
CorporationNon-profit
Incorporated
Jan 2, 1991 in CA
Enrollment address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Grossmont Hospital SharpCCN 05T026 · All quality measures
Ownership
Government
Certified
Jul 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Grossmont Hospital Corp14 organizations share this tax ID, including this one
Part of
Grossmont Hospital Corp

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Diane Keltner Individual Corporate DirectorBoard Member Jun 17, 2017
Steven R Allsing Individual Corporate DirectorBoard Member Jan 1, 2021
Sharp Healthcare Organization, San Diego, CA Non-profit Operational/Managerial Control May 29, 1991
Brian S Moore Individual Corporate OfficerChairman Jun 1, 2019
Corporate DirectorBoard Member Jun 1, 2016
Dee M Ammon Individual Corporate DirectorBoard Member Jun 1, 2020
Virginia Hall Individual Corporate Director Jun 1, 2025
Ron Oberndorfer Individual Corporate DirectorBoard Member Jun 1, 2017
Christopher D Howard Individual Corporate OfficerPresident and Ced Mar 1, 2019
W-2 Managing EmployeePresident and Ceo Mar 1, 2019
Howard Levenson Individual Corporate Director Jun 1, 2025
Randolph S Lenac Individual Corporate OfficerVice Chair Jun 1, 2019
Corporate DirectorBoard Member Mar 1, 2011
William Evans Individual Corporate OfficerBoard Member Sep 1, 2016
W-2 Managing EmployeeCeo Sep 1, 2016
Brian Potter Individual Corporate Director Jun 1, 2025
Ann Goldberg Individual Corporate Director Jul 1, 2024
Margaret Watkins Individual Corporate Director Jun 1, 2025
John Fonseca Individual Corporate DirectorBoard Member Jun 1, 2019

Owners & managing parties with NPI records 5

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1043293871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8695 SPECTRUM CENTER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231489",
            "telephone_number": "858-499-3025",
            "fax_number": "855-499-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMONT HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROSSMONT HOSPITAL CORPORATION",
        "enumeration_date": "2005-11-25",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-740-4648"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": "080000006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharp Grossmont Hospital Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharp Grossmont Hospital Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.