NPIMap

Organization Active NPI

Ukiah Adventist Hospital

  • Allergy Physician
  • Ukiah, CA
National Provider Identifier
1174583504
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
UKIAH ADVENTIST HOSPITAL
Practice address
275 Hospital Dr
Ukiah, CA 95482-4531
Phone
(707) 462-3111
Fax
(707) 463-7689
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Mr. Parker Pridgen
Title
President
Phone
(707) 456-3010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207KA0200X Primary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X

Addresses

Primary practice location

275 Hospital Dr
Ukiah, CA 95482-4531

Mailing address

PO Box 888867
Los Angeles, CA 90088-8867

Other identifiers 6

IdentifierTypeStateIssuer
ZZZ92403ZOtherCABLUE SHIELD
ZZZ13334ZOtherCABLUE SHIELD
ZZZC2308ZOtherCABLUE SHIELD
ZZZ18251ZOtherCABLUE SHIELD
05433002OtherCAKAISER
ZZZC2307ZOtherCABLUE SHIELD

Other names 1

  • Adventist Health Ukiah Valley Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

National Provider Directory

National Provider Directory
Tax ID family
Ukiah Adventist Hosp PH5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1174583504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888867",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOSPITAL DR",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824531",
            "telephone_number": "707-462-3111",
            "fax_number": "707-463-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UKIAH ADVENTIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "PARKER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-456-3010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ92403Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ13334Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZC2308Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ18251Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "05433002",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZC2307Z",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "275 Hospital Dr",
            "city": "Ukiah",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954824531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adventist Health Ukiah Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.