NPIMap

Organization Active NPI

Mayers Memorial Hospital District

  • Medicare Defined Swing Bed Hospital Unit
  • Fall River Mills, CA
National Provider Identifier
1174737068
Registry record updated May 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MAYERS MEMORIAL HOSPITAL DISTRICT
Practice address
43563 State Highway 299 East
Fall River Mills, CA 96028
Phone
(530) 336-5511
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2011

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

Authorized official

Name
Mr. Matt Rees
Title
Ceo
Phone
(530) 336-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X CA Primary

Addresses

Primary practice location

43563 State Highway 299 East
Fall River Mills, CA 96028

Mailing address

PO Box 459
Fall River Mills, CA 96028
Phone (530) 336-5511

Other identifiers 1

IdentifierTypeStateIssuer
LTC30406FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220802004155 CA Part A Provider - Critical Access Hospital 6305804196 Practice locations: Fall River Mills, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174737068. Details of each certification follow.

Hospital certification: CCN 05Z305

Legal name
MAYERS MEMORIAL HOSPITAL DISTRICT
Organization structure
OtherNon-profit
Enrollment address
43563 Hwy 299E
Fall River Mills, CA 96028-0459
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Allen Albaugh Individual Corporate Director Dec 5, 2008
Travis Lakey Individual W-2 Managing EmployeeCfo Nov 23, 2009
Mayers Memorial Hospital District Organization, Fall River Mills, CA Operational/Managerial Control Feb 11, 2015 100%
Louis Ward Individual W-2 Managing EmployeeCeo Feb 11, 2015 100%

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayers Memorial Hospital DistrictFall River Mills, CA, CCN 051305 Hospital Other (100%) Oct 3, 1969
Mayers Memorial Hospital DistrictFall River Mills, CA, CCN 056416 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Trustee of the SNF
Adp of the SNF		 Oct 2, 1969
Oct 2, 1969
Oct 2, 1969
Oct 2, 1969
Intermountain HospiceFall River Mills, CA, CCN 051738 Hospice Operational/Managerial Control (100%) Jan 1, 1999
Mayers Memorial Hospital DistrictBurney, CA, CCN 058721 Rural health clinic Other Oct 3, 1969

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306108800000",
    "number": "1174737068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "96028",
            "telephone_number": "530-336-5511",
            "fax_number": "530-336-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43563 STATE HIGHWAY 299 EAST",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "96028",
            "telephone_number": "530-336-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYERS MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2011-05-23",
        "status": "A",
        "authorized_official_last_name": "REES",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-336-5511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC30406F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River Mills, CA

Sources for this page

Verify at the official NPI Registry.