Organization Active NPI

Chowchilla Memorial Healthcare District

  • Skilled Nursing Facility
  • Chowchilla, CA
National Provider Identifier
1104990688
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
040000083 Issued in CA
Legal business name
CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT
Practice address
1104 Ventura Ave
Chowchilla, CA 93610-2244
Phone
(559) 665-3781
Fax
(559) 665-7195
NPI assigned
Nov 17, 2006
Last updated
Jun 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Ms. Cathy J Flores
Title
Ceo
Phone
(559) 665-3781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 040000083 CA Primary

Addresses

Primary practice location

1104 Ventura Ave
Chowchilla, CA 93610-2244

Mailing address

1104 Ventura Ave
Chowchilla, CA 93610-2244
Phone (559) 665-3781

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000680 CA Part A Provider - Skilled Nursing Facility 2668439852 Practice locations: Chowchilla, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104990688. Details of each certification follow.

Skilled nursing facility certification: CCN 555530

Legal name
CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 23, 1992
Last certification
Feb 24, 2025
Beds
29
Ownership / control type
Other Nonprofit
Organization structure
OtherNon-profit
Incorporated
Mar 25, 1957 in CA
Enrollment address
1104 Ventura Ave
Chowchilla, CA 93610-2244
Nursing home name
CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Chowchilla Memorial Healthcare DistrictCCN 555530 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Oct 23, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2928.7 residents per day on average
Penalties (3 years)
20Fines totaling $112,195

Processed by Care Compare on Aug 1, 2026.

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
05D2037938Chowchilla Memorial Healthcare District1104 Ventura Avenue, Chowchilla, CA 93610Certificate of waiverMar 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Chowchilla Dist Mem Hos2 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.

Locations

1104 Ventura Ave
Chowchilla, CA 93610
Phone (209) 383-1850

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Chowchilla Memorial Healthcare District Organization, Chowchilla, CA Operational/Managerial Control Jan 1, 2005
Leland Decker Individual Corporate Director Jan 21, 2005
Cathy Flores Individual Corporate Director Jan 21, 2005
W-2 Managing Employee Jul 22, 1991

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1104990688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 VENTURA AVE",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936102244",
            "telephone_number": "559-665-3781",
            "fax_number": "559-665-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 VENTURA AVE",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936102244",
            "telephone_number": "559-665-3781",
            "fax_number": "559-665-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOWCHILLA MEMORIAL HEALTHCARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-665-3781",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "040000083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chowchilla, CA

Sources for this page

Verify at the official NPI Registry.