NPIMap

Organization Active NPI

Fresno Community Hospital and Medical Center

Doing business as Community Regional Medical Center

  • General Acute Care Hospital
  • Fresno, CA
National Provider Identifier
1104906569
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
040000096 Issued in CA
Legal business name
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Doing business as
Community Regional Medical Center
Practice address
2823 Fresno St
Fresno, CA 93721-1324
Phone
(559) 459-1672
Fax
(559) 459-1058
NPI assigned
Oct 17, 2006
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Mr. Craig Allen Wagoner
Title
Ceo
Phone
(559) 324-4266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 040000096 CA Primary

Addresses

Primary practice location

2823 Fresno St
Fresno, CA 93721-1324

Mailing address

2823 Fresno St
PO Box 1232
Fresno, CA 93721-1324
Phone (559) 459-6000

Other names 1

  • Community Regional Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021127000007 CA Part A Provider - Hospital 3173430865 Practice locations: Clovis, CA; Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104906569. Details of each certification follow.

Hospital certification: CCN 050060

Legal name
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Doing business as
COMMUNITY REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 27, 2026
Beds
794
Ownership / control type
Private (not for profit)
Most recent change of ownership
Sep 1, 2015 (3 total)
Organization structure
CorporationNon-profit
Incorporated
Jul 13, 1945 in CA
Enrollment address
2823 Fresno St
Fresno, CA 93721-1324
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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: Hospital

Medicare Care Compare
Listed as
Community Regional Medical CenterCCN 050060 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0688073Community Regional Medical Center2823 Fresno St, Clinical Lab Admin, Fresno, CA 93721AccreditationJun 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
Fresno Community Hospital22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations (25 of 89)

2400 Wible Rd
Ste 14
Bakersfield, CA 93304
Phone (661) 725-4780

2400 Balfour Rd
Ste 201
Brentwood, CA 94513
Phone (925) 308-8112

200 W Bullard Ave
Ste D2
Clovis, CA 93612
Phone (559) 298-3668

2086 Shaw Ave
Bldg D
Clovis, CA 93611

2176 Shaw Ave
Clovis, CA 93611
Phone (559) 272-2251

245 W Herndon Ave
Clovis, CA 93612
Phone (559) 299-1178

255 W Bullard Ave
Ste 102
Clovis, CA 93612
Phone (559) 299-2128

255 W Bullard Ave
Ste 112
Clovis, CA 93612
Phone (559) 498-0268

275 W Herndon Ave
Clovis, CA 93612
Phone (559) 321-4255

3120 Willow Ave
Ste 101
Clovis, CA 93612
Phone (559) 370-8694

688 N Medical Center Dr E
Ste 106
Clovis, CA 93611
Phone (559) 297-8604

729 N Medical Center Dr W
#22323
Clovis, CA 93611

729 N Medical Center Dr W
Ste 215
Clovis, CA 93611
Phone (559) 324-6800

785 N Medical Center Dr W
Clovis, CA 93611
Phone (559) 387-1600

785 N Medical Center Dr W
#203
Clovis, CA 93611
Phone (559) 387-1900

3144 Santa Anita Ave
El Monte, CA 91733
Phone (626) 401-4147

1045 S St
Fresno, CA 93721
Phone (559) 256-2150

1187 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (559) 440-0450

1191 E Herndon Ave
Ste 101
Fresno, CA 93720
Phone (559) 431-3838

1247 E Alluvial Ave
Fresno, CA 93720
Phone (559) 370-8694

1275 E Spruce Ave
Ste 101
Fresno, CA 93720
Phone (559) 226-0848

1300 N Fresno St
Ste 220
Fresno, CA 93703
Phone (209) 495-6702

1313 E Herndon Ave
#203210
Fresno, CA 93720

1313 E Herndon Ave
Ste 102
Fresno, CA 93720
Phone (559) 439-6808

135 W Shaw Ave
Ste 100
Fresno, CA 93704
Phone (559) 721-4110

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Keith B Boone Individual Corporate DirectorBoard MBR Jan 1, 2019
Deborah P Moffett Individual Corporate OfficerVice Treasurer Jan 1, 2019
W-2 Managing EmployeeVice President, Finance Administ Jan 1, 2013
Operational/Managerial ControlVice Treasurer Jan 1, 2013
Susan M Abundis Individual Corporate DirectorBoard Member Jan 1, 2019
Gregory L Copeland Individual Corporate DirectorBoard Member Feb 25, 2025
Gregory Carl Estep Individual Corporate DirectorBoard Member Jan 1, 2020
Roger E Sturdevant Individual Corporate OfficerChair Apr 12, 2023
Corporate DirectorBoard Member Jan 1, 2019
Craig Wagoner Individual Corporate OfficerChief Executive Officer Feb 3, 2025
W-2 Managing EmployeeChief Executive Officer Feb 3, 2025
Operational/Managerial ControlChief Executive Officer Feb 3, 2025
Gerardo Hernandez Individual Corporate DirectorBoard Member Jun 6, 2023
Wagih William Ibrahim Individual Corporate DirectorBoard Member Jan 1, 2021
Nicholas David Dugan Individual Corporate DirectorBoard Member Feb 25, 2025
Mark J Coelho Individual Corporate DirectorBoard Member Feb 7, 2023
Fabiola Gonzalez Individual Corporate DirectorBoard Member May 20, 2025
Isabel D Martinez Individual Corporate OfficerVice Secretary Jan 1, 2023
Chandrasekar Venugopal Individual Corporate DirectorBoard Member Jan 1, 2019
Leland D Parnagian Individual Corporate DirectorBoard Member Feb 7, 2023
Christopher M Neuman Individual Corporate OfficerChief Financial Officer Jan 1, 2023
W-2 Managing EmployeeChief Financial Officer Jan 1, 2023
Operational/Managerial ControlChief Financial Officer Jan 1, 2023
Lori Anne Bennett Individual Corporate DirectorBoard Member May 4, 2022
Community Hospitals of Central California Organization, Clovis, CA Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Sep 10, 1982 100%
Operational/Managerial Control Dec 1, 2002
Katherine R. Melendez Individual Corporate OfficerSecond Vice Secretary Jan 1, 2023
Karen M McCaffrey Individual Corporate OfficerBoard Secretary Jan 1, 2023
Corporate DirectorBoard Member May 7, 2019

Owners & managing parties with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 920

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.

View all 920

Affiliated clinicians 1,073

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

View all 1,073

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1104906569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "address_2": "PO BOX 1232",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-6000",
            "fax_number": "559-459-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211324",
            "telephone_number": "559-459-1672",
            "fax_number": "559-459-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-324-4266",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "040000096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Community Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.