NPIMap

Organization Active NPI

Coalinga Medical Center, LLC

  • Meals Provider
  • Coalinga, CA
National Provider Identifier
1184655052
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Meals ProviderTaxonomy code 174200000X
Legal business name
COALINGA MEDICAL CENTER, LLC
Practice address
1191 Phelps Ave
Coalinga, CA 93210-9609
Phone
(559) 935-6562
Fax
(559) 935-6596
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Tammy Jean Thompson
Title
Executive VP/Cfo
Phone
(209) 287-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Meals Provider 174200000X Primary

Addresses

Primary practice location

1191 Phelps Ave
Coalinga, CA 93210-9609

Mailing address

700 17TH St Ste 205
Modesto, CA 95354-1249
Phone (209) 287-6308

Other identifiers 3

IdentifierTypeStateIssuer
HSP40397FMedicaidCA
ZZR00397FMedicaidCA
LTC55539FMedicaidCA

Other names 1

  • COALINGA REGIONAL MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coalinga Medical Center LLC5 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1184655052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 17TH ST STE 205",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541249",
            "telephone_number": "209-287-6308",
            "fax_number": "209-248-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 PHELPS AVE",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932109609",
            "telephone_number": "559-935-6562",
            "fax_number": "559-935-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COALINGA MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "209-287-6308"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40397F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR00397F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55539F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COALINGA REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coalinga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.