NPIMap

Organization Active NPI

Community Memorial Health System

  • Multi-Specialty Clinic/Center
  • Oxnard, CA
National Provider Identifier
1124067574
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COMMUNITY MEMORIAL HEALTH SYSTEM
Practice address
250 Citrus Grove LN
#150
Oxnard, CA 93036-9030
Phone
(805) 981-3770
Fax
(805) 981-3767
NPI assigned
Jun 4, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MEMORIAL HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mr. Gary Wilde
Title
Ceo
Phone
(805) 652-5011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
VA Clinic/Center 261QV0200X

Addresses

Primary practice location

250 Citrus Grove LN
#150
Oxnard, CA 93036-9030

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Other names 1

  • CMH Centers for Family Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422001668 CA Part B Supplier - Clinic/Group Practice 9537155676 Receives reassigned benefits from 274 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ventura, CA; Port Hueneme, CA; Oxnard, CA; Camarillo, CA; Fillmore, CA; Ojai, CA

Other NPIs on the same Medicare enrollment 21

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

View all 21

National Provider Directory

National Provider Directory
Part of
Community Memorial Hosp

Locations

250 Citrus Grove Ln
Ste 150
Oxnard, CA 93036
Phone (805) 981-3770

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1124067574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CITRUS GROVE LN",
            "address_2": "#150",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930369030",
            "telephone_number": "805-981-3770",
            "fax_number": "805-981-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEMORIAL HEALTH SYSTEM",
        "enumeration_date": "2006-06-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-652-5011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMH Centers for Family Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.