Active NPI
Chowchilla Memorial Healthcare District
- Skilled Nursing Facility
- Chowchilla, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 040000083
- 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, 2021
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Other
- 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 District
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Oct 23, 1992
- Medicare certification status
- Active
- Certified beds
- 29
- Penalties (3 years)
- 20
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2037938 | Chowchilla Memorial Healthcare District | Certificate of waiver | Mar 7, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Chowchilla Dist Mem Hos
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Chowchilla Medical Center
- Clinic/Center
- Chowchilla, CA
- NPI 1295800415
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Chowchilla Memorial Healthcare District | Operational/Managerial Control | Jan 1, 2005 | |
| Leland Decker | Corporate Director | Jan 21, 2005 | |
| Cathy Flores | 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
- Danilo D. Ching, M.D.
- Laura Choi
- Chowchilla Care Holdings, LLC (Invigorate Post Acute of Chowchilla)
- Chowchilla Elementary School District
- Chowchilla Healthcare Inc
- Chowchilla Memorial Healthcare District (Chowchilla Wellness Center)
- Chowchilla Memorial Healthcare District (Chowchilla Medical Center)
- Chowchilla Union High School District
- Ashley Clay-Guill
- Jessica Vaughan Clover
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.