Organization Active NPI

Pioneers Memorial Healthcare District

  • General Acute Care Hospital
  • Brawley, CA
National Provider Identifier
1073519443
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PIONEERS MEMORIAL HEALTHCARE DISTRICT
Practice address
207 W Legion Rd
Brawley, CA 92227-7780
Phone
(760) 351-3590
Fax
(760) 351-3312
NPI assigned
Jun 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Mrs. Carly Loper
Title
Chief Financial Officer
Phone
(760) 351-3594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X CA Primary
Skilled Nursing Facility 314000000X

Addresses

Primary practice location

207 W Legion Rd
Brawley, CA 92227-7780

Mailing address

207 W Legion Rd
Brawley, CA 92227-7780
Phone (760) 351-3590

Other practice location 1

320 Cattle Call Dr
Brawley, CA 92227-3108
Phone (760) 344-5431

Other identifiers 15

IdentifierTypeStateIssuer
1509782MedicaidNY
ZZT40342FMedicaidCA
ZZZC1301ZOtherBLUE SHIELD
021709MedicaidAZ
A6816MedicaidNM
131561105MedicaidAK
4105270MedicaidMT
3161908MedicaidWA
039487MedicaidOR
050342B000000OtherCACMS 1011 PROGRAM
050342OtherBLUE CROSS
1716235MedicaidTX
201112200OtherUS DEPT OF LABOR
CP3327OtherCAMEDICARE RAILROAD
ZZT30342FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051014000744 CA Part B Supplier - Clinic/Group Practice 4082527593 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Brawley, CA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

751 W Legion Rd
Brawley, CA 92227
Phone (760) 351-0025

205 W Legion Rd
Ste 1
Brawley, CA 92227
Phone 6024419520800

731 Cesar Chavez Blvd
Calexico, CA 92231
Phone (760) 357-4850

1121 S 4th St
Ste D
El Centro, CA 92243
Phone (760) 336-3000

Dept LA 23624
Pasadena, CA 91185

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/11d6e9da-d3d5-4352-8d64-f06e0d461c57/

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1073519443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3590",
            "fax_number": "760-351-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3590",
            "fax_number": "760-351-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Cattle Call Dr",
            "address_purpose": "LOCATION",
            "city": "Brawley",
            "state": "CA",
            "postal_code": "922273108",
            "country_code": "US",
            "telephone_number": "760-344-5431",
            "fax_number": "760-344-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIONEERS MEMORIAL HEALTHCARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "LOPER",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "760-351-3594",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509782",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40342F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZC1301Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021709",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A6816",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131561105",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4105270",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3161908",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039487",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS 1011 PROGRAM",
            "identifier": "050342B000000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050342",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1716235",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "201112200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CP3327",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30342F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.