Fern Lodge, Inc.

Primary specialty

Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X

Legal business name

FERN LODGE, INC.

Practice address

18457 Madison Ave
Castro Valley, CA 94546-1637

Phone

(510) 886-2448

Fax

(510) 886-5992

NPI assigned

Oct 11, 2007

Last updated

Jan 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. George Strong

Title

Administrator

Phone

(510) 886-2448

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114115417. Details of each certification follow.

• CCN 051994 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 051994

Legal name

FERN LODGE, INC

Certification status

Terminated Voluntary: other reason for withdrawal, Jul 1, 2018

Provider type (POS)

Hospital – Religious non-medical health care institution

Participating since

Oct 9, 2007

Last certification

Sep 13, 2007

Beds

28

Ownership / control type

Church

Facility address

18457 Madison Avenue
Castro Valley, CA 94546

Locations

Practitioners 2

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.

• Heather Beck

  • Religious Nonmedical Nursing Personnel
  • Castro Valley, CA
  • NPI 1356739163
  NPD (past)
• Sharon Marie Strong

  • Religious Nonmedical Nursing Personnel
  • Castro Valley, CA
  • NPI 1386993236
  NPD (past)

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1114115417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18457 MADISON AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945461637",
            "telephone_number": "510-886-2448",
            "fax_number": "510-886-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18457 MADISON AVE",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945461637",
            "telephone_number": "510-886-2448",
            "fax_number": "510-886-5992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERN LODGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "STRONG",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "510-886-2448",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joell Farrar
• Joseph P Farrell, PHYSICAL THERAPIST
• Farnoosh Farrokhi
• Teofik Fehimovic
• Li Feng Feng
• Cynthia Ann Ferrari, M.S., M.F.T.
• Alan G Fierro, D.D.S.
• Rhodora Maliglig Finch
• Chrisantes Pauline Finister, LPT
• Floyd Finney, PH.D.

• Religious Nonmedical Health Care Institution in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Religious Nonmedical Health Care Institution in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.