Valley Children's Hospital

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

040000160 Issued in CA

Legal business name

VALLEY CHILDREN'S HOSPITAL

Doing business as

Charlie Mitchell Rural Health Clinic

Practice address

9300 Valley Childrens PL
Madera, CA 93636-8762

Phone

(559) 353-3000

NPI assigned

Dec 13, 2006

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tina Mycroft

Title

Senior VP & Cfo

Phone

(559) 353-3000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Charlie Mitchell Rural Health Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063573962. Details of each certification follow.

• CCN 058603 Rural health clinic · Active · Details

Rural health clinic certification: CCN 058603

Legal name

VALLEY CHILDRENS HOSPITAL

Doing business as

CHARLIE MITCHELL RURAL HEALTH CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 22, 2004

Last certification

Apr 3, 2019

Ownership / control type

2B

Organization structure

CorporationNon-profit

Incorporated

Aug 4, 1949 in CA

Enrollment address

41169 Goodwin Way
Madera, CA 93636-8766

Related CCNs

053300

Related certifications (CCN) 2

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

• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1275694184

  Parent provider

  Provider of Services
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 2

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

• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1275694184

  3476461070

  Same PAC ID
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043

  3476461070

  Same PAC ID

Tax ID family

Children's Hospital Central California11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

• Children's Hospital Central California

  • Children's Hospital
  • Madera, CA
  • NPI 1235474198
  NPD tax ID
• Children's Hospital Central California Campus Pharmacy

  • Pharmacy
  • Madera, CA
  • NPI 1558321307
  NPD tax ID
• Childrens Hospital Central California

  • Children's Hospital
  • Fresno, CA
  • NPI 1447683826
  NPD tax ID
• Childrens Hospital Homecare

  • Oxygen Equipment & Supplies (DME)
  • Fresno, CA
  • NPI 1508937277
  NPD tax ID
• Valley Children's Hospital

  dba Valley Children's Home Care

  • Home Infusion Therapy Pharmacy
  • Fresno, CA
  • NPI 1275612673
  NPD tax ID
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1700949336
  NPD tax ID
• Valley Children's Hospital

  • Home Health Agency
  • Fresno, CA
  • NPI 1710058151
  NPD tax ID
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1891858429
  NPD tax ID
• Valley Children's Hospital

  • Children's Hospital
  • Hanford, CA
  • NPI 1902968118
  NPD tax ID
• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6226/brand/1/csg/1/fhir/r4

All disclosed owners & managing parties 36

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

Owners & managing parties with NPI records 2

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

• Christine Marie Almon, M.D.

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1497766141

  Corporate Director

  CMS ownership
• Karen M Dahl, MD

  • Pediatric Infectious Diseases Physician
  • Madera, CA
  • NPI 1790756211

  Operational/Managerial Control

  CMS ownership

Facilities with the same owner 1

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

• Valley Children's Hospital

  • Children's Hospital
  • Madera, CA
  • NPI 1952312043

  Valley Children's Healthcare

  CMS ownership

Practitioners 11

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.

• Patrick B Burke, M.D.

  • Internal Medicine Physician
  • Madera, CA
  • NPI 1942456165
  NPD (past)
• James Clifton Horspool, DO

  • Pediatrics Physician
  • Madera, CA
  • NPI 1174503338
  NPD (past)
• Jennifer Johnson, MD

  • Developmental - Behavioral Pediatrics Physician
  • Madera, CA
  • NPI 1194143057
  NPD (past)
• Peter Michael Nakaguchi, M.D.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1750393617
  NPD (past)
• Hailey Diane Nelson, M.D.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1427311927
  NPD (past)
• Navjot Kaur Sidhu, MD

  • Developmental - Behavioral Pediatrics Physician
  • Madera, CA
  • NPI 1306339080
  NPD (past)
• Carmela Elaine Sosa, M.D.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1538392642
  NPD (past)
• Erin Vaughn, MD

  • Pediatrics Physician
  • Madera, CA
  • NPI 1528234200
  NPD (past)
• Neepa J. Ved, M.D.

  • Pediatrics Physician
  • Madera, CA
  • NPI 1235177742
  NPD (past)
• Albert Vu, MD

  • Pediatrics Physician
  • Madera, CA
  • NPI 1194245563
  NPD (past)
• Ama Shankini Wijegunawardena, MD

  • Pediatrics Physician
  • Madera, CA
  • NPI 1649583410
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1063573962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368762",
            "telephone_number": "559-353-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368762",
            "telephone_number": "559-353-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "MYCROFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "559-353-3000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "040000160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD RHC PID",
            "identifier": "ZZZ64542Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM1860F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlie Mitchell Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Valenzuela
• Kristina Irene Valenzuela
• Cori Valeriote, RD
• Aimee Vallejo
• Julie Valles
• Valley Children's Hospital
• Valley Children's Hospital
• Valley Children's Hospital
• Valley Children's Hospital
• Valley Children's Hospital

• Rural Health Clinic/Center in Madera, CA
• Providers in Madera, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.