NPIMap

Organization Active NPI

Sharp Memorial Hospital

Doing business as Sharp Allison deRose Rehabilitation Center

  • Rehabilitation Hospital Unit
  • San Diego, CA
National Provider Identifier
1114901352
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
080000039 Issued in CA
Legal business name
SHARP MEMORIAL HOSPITAL
Doing business as
Sharp Allison deRose Rehabilitation Center
Sharp Memorial Rehabilitation Center
Practice address
2999 Health Center Dr
San Diego, CA 92123-2762
Phone
(858) 939-3400
Fax
(858) 499-4738
NPI assigned
Dec 1, 2005
Last updated
Feb 27, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SHARP MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Authorized official

Name
Tim Smith
Title
Ceo
Phone
(858) 939-4082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 080000039 CA Primary

Addresses

Primary practice location

2999 Health Center Dr
San Diego, CA 92123-2762

Mailing address

8695 Spectrum Center Blvd
San Diego, CA 92123-1489
Phone (858) 499-3025

Other names 2

  • Sharp Allison deRose Rehabilitation Center Doing business as
  • Sharp Memorial Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071011000716 CA Part A Provider - Hospital 2961396841 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA
O20071127000851 CA Part A Provider - Hospital 2961396841 Practice locations: San Diego, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1114901352. Details of each certification follow.

Hospital certification: CCN 050100

Legal name
SHARP MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 9, 2018
Beds
881
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 14, 1981 in CA
Enrollment address
7901 Frost St
San Diego, CA 92123-2701
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Rehabilitation, Other

Hospital certification: CCN 05T100

Legal name
SHARP MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Sep 14, 1981 in CA
Enrollment address
2999 Health Center Dr
San Diego, CA 92123-2762
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Sharp Memorial HospitalCCN 050100 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Sharp Memorial Rehabilitation CenterCCN 05T100 · All quality measures
Ownership
Non-profit
Certified
Oct 1, 1983

National Provider Directory

National Provider Directory
Part of
Sharp Memorial Hosp Pat

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Sharp Healthcare

    dba Sharp Rees-Stealy Clincial Laboratory - Rancho Bernado

    • Clinical Medical Laboratory
    • San Diego, CA
    • NPI 1578530952

    Member Of

    NPD member

Locations (25 of 35)

1905 Calle Barcelona
Ste 211
Carlsbad, CA 92009
Phone (858) 766-6007

6125 Paseo del Norte
Ste 200
Carlsbad, CA 92011
Phone (760) 585-2662

2300 Boswell Rd
Ste 130
Chula Vista, CA 91914
Phone (619) 837-8902

344 F St
Ste 300
Chula Vista, CA 91910
Phone (619) 585-4080

1452 S La Brucherie Rd
#A
El Centro, CA 92243

310 Santa Fe Dr
Ste 110
Encinitas, CA 92024

351 Santa Fe Dr
Ste 240
Encinitas, CA 92024
Phone (619) 691-0388

215 S Hickory St
Ste 212
Escondido, CA 92025
Phone (760) 737-2020

555 E Valley Pkwy
Escondido, CA 92025
Phone (760) 739-3000

1780 E Florida Ave
Hemet, CA 92544
Phone (714) 636-0342

2390 E Florida Ave
Ste 207
Hemet, CA 92544
Phone (951) 652-6100

4150 Regents Park Row
Ste 345
La Jolla, CA 92037
Phone (858) 207-3117

8262 University Ave
La Mesa, CA 91942
Phone (619) 668-0045

8860 Center Dr
Ste 450
La Mesa, CA 91942
Phone (619) 460-6200

11620 Wilshire Blvd
Ste 102
Los Angeles, CA 90025
Phone (310) 423-4800

2809 Olive Hwy
Ste 310
Oroville, CA 95966
Phone (530) 532-8654

15611 Pomerado Rd
Ste 500
Poway, CA 92064
Phone (858) 292-7527

10737 Camino Ruiz
Ste 200
San Diego, CA 92126
Phone (858) 653-0147

12264 El Camino Real
Ste 111
San Diego, CA 92130
Phone (858) 509-1259

2017 1st Ave
Ste 100
San Diego, CA 92101
Phone (619) 881-4516

2929 Health Center Dr
Ste 106
San Diego, CA 92123

3590 Camino del Rio N
Ste 102
San Diego, CA 92108
Phone (619) 810-1202

4060 4th Ave
Ste 310
San Diego, CA 92103
Phone (619) 297-4707

4340 Genesee Ave
Ste 207
San Diego, CA 92117
Phone (858) 356-5600

4540 Kearny Villa Rd
Ste 106
San Diego, CA 92123
Phone (858) 430-6656

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Blair P Henderson Individual Corporate Director Jan 1, 2026
Marilyn Creson Brown Individual Corporate OfficerTreasurer Aug 1, 2023
Philip Gildred Individual Corporate DirectorBoard Member Aug 1, 2019
Charles a Athill Individual Corporate DirectorBoard Member Aug 1, 2020
Stephanie Benvenuto Individual Corporate OfficerChair Aug 1, 2023
Sharp Healthcare Organization, San Diego, CA Non-profit 5% Or Greater Direct Ownership Interest Sep 10, 1981 100%
Operational/Managerial Control Sep 10, 1981
Richard D Coutts Individual Corporate DirectorBoard Member Aug 1, 2019
Paola Avila Individual Corporate DirectorBoard Member Feb 1, 2021
Patricia Khaleghi Individual Corporate OfficerSVP, Market Ceo Oct 30, 2022
W-2 Managing EmployeeSVP, Market Ceo Apr 8, 1991
Corporate DirectorSVP, Market Ceo Oct 30, 2022
W-2 Managing EmployeeSVP, Market Ceo Mar 16, 2020
Jonathan J Gray Individual Corporate Director Oct 1, 2024
Christopher D Howard Individual Corporate OfficerBoard Member Dec 1, 2019
W-2 Managing EmployeePres/Ceo SHC Feb 1, 2019
Corporate OfficerPresident/Ceo Feb 1, 2019
Casey Castillo Individual Corporate Director Aug 1, 2023
Emily Cole Individual Corporate OfficerSecretary Aug 1, 2023
Frederick G Johnson Individual Corporate DirectorBoard Member Aug 1, 2022
James Smith Individual Corporate Director Oct 1, 2017
Jershonda F Hartsfield Individual Corporate Director Jan 1, 2024
Derek Quackenbush Individual Corporate DirectorVice Chair Aug 1, 2023
Corporate Director Aug 1, 2023
Christopher Thomas Walker Individual Corporate Director May 20, 2024
W-2 Managing EmployeeAd; Mar 6, 2000

Owners & managing parties with NPI records 8

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Practitioners 1,068

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 1,068

Affiliated clinicians 916

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

View all 916

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1114901352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8695 SPECTRUM CENTER BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231489",
            "telephone_number": "858-499-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2999 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232762",
            "telephone_number": "858-939-3400",
            "fax_number": "858-499-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARP MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHARP MEMORIAL HOSPITAL",
        "enumeration_date": "2005-12-01",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-939-4082"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": "080000039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharp Allison deRose Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharp Memorial Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharp Memorial Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.