NPIMap

Organization Active NPI

Community Memorial Health System

Doing business as Community Memorial Hospital - Ventura

  • General Acute Care Hospital
  • Ventura, CA
National Provider Identifier
1215903018
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
COMMUNITY MEMORIAL HEALTH SYSTEM
Doing business as
Community Memorial Hospital - Ventura
Practice address
147 N Brent St
Ventura, CA 93003-2809
Phone
(805) 652-5011
Fax
(805) 585-3007
NPI assigned
Feb 23, 2006
Last updated
Apr 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Mr. Michael Zdeblick
Title
President & Ceo
Phone
(805) 652-5011

Specialties & licenses 1

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

Addresses

Primary practice location

147 N Brent St
Ventura, CA 93003-2809

Mailing address

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Other identifiers 8

IdentifierTypeStateIssuer
050394OtherCABLUE CROSS PROVIDER NO
ZZZ53994ZOtherCABLUE SHIELD
RHM08608FMedicaidCA
ZZT40394FMedicaidCA
HSC30394FMedicaidCA
RHM08609FMedicaidCA
RHM18553HMedicaidCA
ZZZA5603ZOtherCABLUE SHIELD

Other names 2

  • Community Memorial Hospital - Ventura Doing business as
  • Community Memorial Hospital of San Buena Ventura Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA4 enrollments

Enrollment records 4

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
Practice locations: Ventura, CA; Port Hueneme, CA; Oxnard, CA; Camarillo, CA; Fillmore, CA; Ojai, CA
O20040817001490 CA Part A Provider - Rural Health Clinic 9537155676 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Paula, CA
O20040908000704 CA Part A Provider - Rural Health Clinic 9537155676 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fillmore, CA
O20071219000370 CA Part A Provider - Hospital 9537155676 9 other NPIs on this enrollment
Practice locations: Ventura, CA; Camarillo, CA; Oxnard, CA; Port Hueneme, CA; Ojai, CA

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1215903018. Details of each certification follow.

Rural health clinic certification: CCN 058609

Legal name
COMMUNITY MEMORIAL HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 16, 2004
Last certification
Jan 29, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 13, 1933 in CA
Enrollment address
242 E Harvard Blvd
Ste C
Santa Paula, CA 93060-3372
Related CCNs
050394

Rural health clinic certification: CCN 058608

Legal name
COMMUNITY MEMORIAL HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 17, 2004
Last certification
Jan 30, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 13, 1933 in CA
Enrollment address
852 W Ventura St
Fillmore, CA 93015-1837
Related CCNs
050394

Hospital certification: CCN 050394

Legal name
COMMUNITY MEMORIAL HEALTH SYSTEM
Doing business as
COMMUNITY MEMORIAL HOSPITAL - VENTURA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 5, 2026
Beds
242
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 13, 1933 in CA
Enrollment address
147 N Brent St
Ventura, CA 93003-2809
Main/Primary Hospital Location
Hospital subgroups
General

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

View all 13

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 22

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

View all 22

Care Compare: Hospital

Medicare Care Compare
Listed as
Community Memorial Hospital - VenturaCCN 050394 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0694958Comm Mem Hosp of San Buena Ventura/Lab147 N Brent St, Ventura, CA 93003AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: annschraderkelley@cmhealthsys.allscriptsdirect.net
  • Direct secure messaging: christinamatts@cmhealthsys.allscriptsdirect.net

Ownership & related parties

All disclosed owners & managing parties 32

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

NameRoleSinceShare
Jeffrey C Brackett Individual Corporate DirectorDirector/Officer Nov 1, 2017
Corporate Director Feb 1, 2017
Corporate Director Nov 1, 2017
Deborah E Carlson Individual Corporate Director Jan 1, 2019
William J Kearney Individual Corporate OfficerBoard Member Jan 1, 2014
Corporate Director Feb 1, 2017
Corporate OfficerBoard Member Jan 1, 2013
Martin a Pops Individual Corporate Director Nov 28, 2007
Corporate Director Feb 1, 2017
Jeffrey D Paul Individual Corporate OfficerBoard Member Jan 1, 2014
Corporate Director Feb 1, 2017
Corporate OfficerBoard Member Jan 1, 2013
Celina Zacarias Individual Corporate Director Jan 1, 2021
Michael Zdeblick Individual Corporate OfficerChief Executive Officer Jan 9, 2023
Corporate DirectorCeo and President Jan 9, 2023
W-2 Managing Employee Jan 9, 2023
Miranda Margetts Individual Corporate Director Jan 1, 2021
Lydia Hopps Individual Corporate DirectorDirector/Officer Nov 1, 2017
Corporate Director Feb 1, 2017
Corporate Director Nov 1, 2017
Christopher D Johnson Individual Corporate Director Jan 1, 2021
Jeffrey W Loebl Individual Corporate Director Jan 1, 2021
Gary L Wolfe Individual Corporate Director Nov 28, 2007
Corporate Director Sep 3, 2004
Corporate Director Sep 27, 2004
Judith H Norris Individual Corporate Director Jan 1, 2021
David Fukutomi Individual Corporate DirectorDirector/Officer Nov 1, 2017
Corporate Director Feb 1, 2017
Corporate Director Nov 1, 2017
Richard R Rush Individual Corporate OfficerBoard Member Jan 1, 2014
Corporate Director Feb 1, 2017
Corporate OfficerBoard Member Jan 1, 2013
Elizabeth H Pavlov Individual Corporate Director Jan 1, 2021
John J Hammer Individual Corporate Director Nov 28, 2007
Corporate Director Sep 3, 2004
Corporate Director Sep 27, 2004
Michael D Bradbury Individual Corporate Director Nov 28, 2007
Corporate Director Sep 3, 2004
Corporate Director Sep 27, 2004
Catherine Dixon Ferguson Individual Corporate Director Jan 1, 2021
Timothy J Gallagher Individual Corporate Director Nov 28, 2007
Corporate Director Feb 1, 2017
Corporate OfficerBoard Member Jan 1, 2013
Frederick T Muegenburg Individual Corporate Director Nov 28, 2007
Corporate Director Feb 1, 2017
Community Memorial Health System Organization, Ventura, CA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Linda Pettit Individual Corporate Director Jan 1, 2021
John V Hill Individual Corporate Director Sep 3, 2004
Corporate Director Sep 27, 2004
Lamar J Bushnell Individual Corporate Director Feb 1, 2017
Corporate Director Nov 1, 2017
Edie Marshall Individual Corporate Director Feb 1, 2017
Helen Petroff Individual Corporate Director Feb 1, 2017
Roy a Schneider Individual Corporate Director Feb 1, 2017
John W Russell Individual Corporate Director Feb 1, 2017
Corporate Director Nov 28, 2007
Gregory Smith Individual Corporate Director Sep 3, 2004
Gertrude Cook Individual Corporate Director Jan 1, 2019
Carl a Constantine Individual Corporate Director Jan 1, 2019

Owners & managing parties with NPI records 13

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

View all 13

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Community Memorial Continuing Care CenterOjai, CA, CCN 056200 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Aug 1, 2005
Mar 4, 2025

Owned or controlled facilities with NPI records 10

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 476

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 476

Affiliated clinicians 565

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 565

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1215903018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5011",
            "fax_number": "805-585-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5011",
            "fax_number": "805-585-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "ZDEBLICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "805-652-5011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NO",
            "identifier": "050394",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ53994Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08608F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40394F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30394F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08609F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18553H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZA5603Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Memorial Hospital - Ventura",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Memorial Hospital of San Buena Ventura",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Community Memorial Hospital of San Buena Ventura",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.