NPIMap

Organization Active NPI

Willits Hospital Inc.

Doing business as Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
National Provider Identifier
1083602122
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
110000013 Issued in CA
Legal business name
WILLITS HOSPITAL INC.
Doing business as
Adventist Health Howard Memorial
Practice address
1 Marcela Drive
Willits, CA 95490-5769
Phone
(707) 459-6801
Fax
(707) 459-9486
NPI assigned
Oct 12, 2005
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Parker J Pridgen
Title
President
Phone
(707) 456-3010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 110000013 CA Primary

Addresses

Primary practice location

1 Marcela Drive
Willits, CA 95490-5769

Mailing address

PO Box 888828
Los Angeles, CA 90088-8828
Phone (707) 459-6801

Other names 1

  • Adventist Health Howard Memorial Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071206000000 CA Part A Provider - Critical Access Hospital 7416940697 Practice locations: Willits, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083602122. Details of each certification follow.

Hospital certification: CCN 05Z310

Legal name
WILLITS HOSPITAL INC
Doing business as
ADVENTIST HEALTH HOWARD MEMORIAL
Organization structure
CorporationNon-profit
Incorporated
Oct 3, 1986 in CA
Enrollment address
1 Marcela Dr
Willits, CA 95490-5769
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Willits Hospital Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
John H Cress Individual Corporate DirectorBoard Member Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Eric a Stevens Individual Corporate OfficerPresident & Vice Chair Jul 8, 2024
W-2 Managing Employee Jul 8, 2024
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard Member Jan 1, 2024
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Ann K Beckett Individual Corporate DirectorBoard Member Jan 1, 2024
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jeffrey R Mock Individual Corporate OfficerTreasurer Sep 18, 2023
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Kenneth Jutzy Individual Corporate Director Jan 1, 2024
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Corporation, Non-profit Operational/Managerial Control Oct 1, 1986 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 105

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

View all 105

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1083602122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888828",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888828",
            "telephone_number": "707-459-6801",
            "fax_number": "707-459-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARCELA DRIVE",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954905769",
            "telephone_number": "707-459-6801",
            "fax_number": "707-459-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLITS HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "PARKER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-456-3010"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "110000013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1 Marcela Drive",
            "city": "Willits",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954905769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adventist Health Howard Memorial",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willits, CA

Sources for this page

Verify at the official NPI Registry.