Community Health Systems, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Bloomington, CA
NPI 1093226243 · NPPES record last updated Apr 17, 2026
Key facts
- NPI
- 1093226243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COMMUNITY HEALTH SYSTEMS, INC.
- Practice address
- 18651 Valley Blvd Unit a
Bloomington, CA 92316-1831 - Phone
- (951) 571-2300
- NPI assigned
- Oct 16, 2017
- Organization subpart
- No
Authorized official
- Name
- Lori Holeman
- Title
- Ceo
- Phone
- (951) 571-2300
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 6
Facilities with the same owner 2
Practitioners 22
-
Anthony John Bullum, O.D.
-
Herman A Carstens, M.D.
-
Goran Cvijanovic, MD
-
Jenny Huong Le, O.D.
-
Robert Addison McAuley, M.D.
-
Renee Susette Miles, LCSW
-
Anthony Milliron, MD
-
Gabriel Rodarte, MD
-
Bonnie Jean Campbell, LCSW
-
Brian Knudsen Connolly, PA-C
-
Gabriella Odudu, MD
-
George Soliman, MD
-
Rafael A Rosado-Cosme, M.D.
-
Joetta Lynn Solomon, RNP
-
Aida N Steele, D.D.S.
-
Victoria A Udeh, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 921140
- Legal name
- COMMUNITY HEALTH SYSTEMS INC
- Doing business as
- BLOOMINGTON COMMUNITY HEALTH CENTER- BUILDING 2
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 12, 2018
- Last certification
- Nov 12, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 17, 1984 in CA
- Enrollment address
- 18651 Valley Blvd
Bloomington, CA 92316-1831
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Lisa Michelle Moxley |
W-2 Managing Employee |
Jun 13, 2024 | |
| Denyse Baham |
Corporate Director |
Nov 22, 2024 | |
| Naureen Bano Khan |
W-2 Managing Employee |
Jun 13, 2024 | |
| Regina Leann Mayer |
W-2 Managing Employee |
Jun 13, 2024 | |
| Draymond Crawford |
Corporate Director |
May 1, 1984 | |
| Vanessa I Ortiz |
W-2 Managing Employee |
Aug 16, 2010 | |
| Oscar Ulric Jones |
Corporate Director |
Dec 18, 2007 | |
| Naomi Dearmore |
W-2 Managing Employee |
Jun 13, 2024 | |
| Marina Lopez-Rabindranath |
W-2 Managing Employee |
Jun 13, 2024 | |
| Annie Thao Nguyen |
Corporate Officer |
Mar 1, 2018 | |
| W-2 Managing Employee |
Jun 13, 2024 | ||
| Tracy Robinson |
W-2 Managing Employee |
Jun 13, 2024 | |
| Linda Prieto |
W-2 Managing Employee |
Jun 13, 2024 | |
| Operational/Managerial Control |
Jun 13, 2024 | ||
| Cheryl Whitten |
W-2 Managing Employee |
Jun 13, 2024 | |
| Community Health Systems Inc |
5% Or Greater Direct Ownership Interest | Jun 14, 2024 | 100% |
| Operational/Managerial Control | Jun 14, 2024 | 100% | |
| Jonnathan Barajas |
Corporate Director |
Aug 22, 2017 | |
| Luan T Le |
W-2 Managing Employee |
Jun 13, 2024 | |
| Kimberly Ramos |
Corporate Director |
Aug 22, 2016 | |
| Angel Acevedo |
W-2 Managing Employee |
Jun 13, 2024 | |
| Allison Monterrosa |
Corporate Director |
Jun 27, 2017 | |
| Damien Peteet |
W-2 Managing Employee |
Jun 13, 2024 | |
| Jennifer Dobrowolsky |
Corporate Director |
Nov 11, 2024 | |
| Lori Holeman |
Corporate Officer |
Aug 11, 2008 | |
| W-2 Managing Employee |
Jun 13, 2024 | 100% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Magnolia Community Health Center |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Feb 1, 2012 |
| University Community Heath Center |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 9, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051117000822 | CA | Part B Supplier - Clinic/Group Practice | 7012824717 |
Receives reassigned benefits from 84 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bloomington, CA; Fallbrook, CA; Moreno Valley, CA; Riverside, CA |
| O20181113000735 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 7012824717 | Practice locations: Bloomington, CA |
National Provider Directory
Locations
18651 Valley Blvd
Unit A
Bloomington, CA 92316
Phone (951) 571-2300
617 E Alvarado St
Fallbrook, CA 92028
Phone (760) 509-9509
407 Potter St
Ste G
Fallbrook, CA 92028
Phone (760) 451-8537
22675 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300
21801 Alessandro Blvd
Moreno Valley, CA 92553
Phone (951) 571-2300
8151 Arlington Ave
Ste U
Riverside, CA 92503
Phone (951) 588-0859
8151 Arlington Ave
Riverside, CA 92503
Phone (760) 728-3816
2933 University Ave
Riverside, CA 92507
Phone (951) 224-8220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
18651 Valley Blvd Unit a
Bloomington, CA 92316-1831
Mailing address
7880 Mission Grove Pkwy S
Riverside, CA 92508-6000
Phone (951) 571-2300
Other names
- Bloomington Community Health Center - Building 2
Other providers in Bloomington, CA
- Natalia Chavez Cisneros
- Christina Kinney
- Alexia Cisneros
- Michele C Clark
- Colton Joint Unified School District
- Community Health Systems, Inc.
- Community Health Systems, Inc.
- Community Health Systems, Inc.
- Veronica Contreras
- Deirdre Cooney
All providers in Bloomington, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.