NPIMap

Organization Active NPI

St. Joseph Health Northern California, LLC

Doing business as Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
National Provider Identifier
1215061718
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
140000648 Issued in CA
Legal business name
ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC
Doing business as
Santa Rosa Memorial Hospital
Practice address
1165 Montgomery Dr
Santa Rosa, CA 95405
Phone
(707) 546-3210
Fax
(707) 545-4504
NPI assigned
Mar 15, 2007
Last updated
Aug 15, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ST JOSEPH HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Director-Reimbursement Administrat
Phone
(425) 525-5392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 140000648 CA Primary

Addresses

Primary practice location

1165 Montgomery Dr
Santa Rosa, CA 95405

Mailing address

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

Other names 1

  • Santa Rosa Memorial Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Health Northern California LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1215061718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054801",
            "telephone_number": "707-546-3210",
            "fax_number": "707-545-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 MONTGOMERY DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-546-3210",
            "fax_number": "707-545-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST JOSEPH HEALTH SYSTEM",
        "enumeration_date": "2007-03-15",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DIRECTOR-REIMBURSEMENT ADMINISTRAT",
        "authorized_official_telephone_number": "425-525-5392",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "140000648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Rosa Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Santa Rosa Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.