Ukiah Adventist Hospital
Organization Active NPI General Acute Care Hospital · Ukiah, CA
NPI 1235120676 · NPPES record last updated Jul 17, 2025
Key facts
- NPI
- 1235120676
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 110000095 (CA)
- Legal business name
- UKIAH ADVENTIST HOSPITAL
- Practice address
- 275 Hospital Dr
Ukiah, CA 95482-4531 - Phone
- (707) 463-7360
- Fax
- (707) 463-7689
- NPI assigned
- Nov 3, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Eric Stevens
- Title
- President
- Phone
- (707) 456-3010
Owners & managing parties with NPI records 1
-
Kenneth Jutzy, M.D.
Other NPIs with the same Medicare PAC ID 4
Related certifications (CCN) 3
Facilities with the same owner 105
Practitioners 264
-
Anna Marie Antonowich, MSN, NP-BC
-
Razi M Arifuddin, MD
-
Sunayna Bakaya, M.D.
-
Charles Baugh, MD
-
Ruben R Brechner, M.D.
-
Matthew Audet Cain, M.D.
-
Jack L Chen, M.D.
-
Leonardo C. Clavijo, M.D.
-
Mark W Deseran, MD
-
William Duge, MD
-
Aphrael Genevieve Dunston, FNP, RN
-
Miriam Bradshaw Ellis, LCSW
-
Maia Eng, M.D.
-
Arlene Flores, DO
-
William N Gonser, M.D.
-
Brian Scott Gould, D.O.
-
Ziad Hanna, D.O.
-
Lindsay Helvey, APRN, FNP-C
-
Alireza Hosseini, MD
-
Charles Hudson, MD
Affiliated clinicians 498
-
Shahnaz Achackzad, NPC
-
Chalice Ann Addis, FNP-BC
-
Larry Aguirre II, PA-C, DMSC, CAQ-PSY
-
Arwa Alsamarae, M.D.
-
Sarah Fearing Alvord, M.D.
-
Fariba Amiri, M.D.
-
Paolo Andreassi, M.D.
-
Anna Marie Antonowich, MSN, NP-BC
-
Mark Justin Apfel, M.D.
-
Yonathan Ararso, MD,MS
-
Razi M Arifuddin, MD
-
Fadi Arodaki, DO
-
Henry Ashista, MD, MPH
-
Alexander E Ayala, MD, MPH
-
Christopher Ayeko, FNP
-
Hossein Azadi, MD
-
Pari Azari, M.D.
-
Masis Babajanian, M.D.
Medicare Care Compare: Hospital
- Listed as
- Adventist Health Ukiah Valley
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Hospital certification: CCN 050301
- Legal name
- UKIAH ADVENTIST HOSPITAL
- Doing business as
- ADVENTIST HEALTH UKIAH VALLEY
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Jul 18, 2025
- Beds
- 127 (111 certified)
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 25, 1967 in CA
- Enrollment address
- 275 Hospital Dr
Ukiah, CA 95482-4531 - Hospital subgroups
- General, Acute care, Other
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Kerry L Heinrich |
Corporate Officer |
Jan 1, 2022 | |
| Corporate Director |
Dec 15, 2014 | ||
| John H Cress |
Corporate Officer |
Oct 1, 2024 | |
| Meredith S Jobe |
Corporate Officer |
Mar 31, 2014 | |
| Eric a Stevens |
Corporate Officer |
Jul 8, 2024 | |
| W-2 Managing Employee | Jul 8, 2024 | ||
| Richard K Reiner |
Corporate Director |
Jan 16, 2017 | |
| Joy a. Fehr |
Corporate Director |
Oct 1, 2020 | |
| Jonathan J Daggett |
Corporate Director |
Jan 1, 2024 | |
| Andrew R Davis |
Corporate Director |
May 5, 2017 | |
| Todd N Hofheins |
Corporate Officer |
Jan 24, 2022 | |
| Ann K Beckett |
Corporate Director |
Jan 1, 2024 | |
| Marc K Woodson |
Corporate Director |
Jan 1, 2019 | |
| John C Freedman |
Corporate Director |
Sep 26, 2016 | |
| Jeffrey R Mock |
Corporate Officer |
Sep 18, 2023 | |
| Jack W Wagner |
Corporate Director |
Dec 1, 2022 | |
| Kenneth Jutzy |
Corporate Director |
Jan 1, 2024 | |
| Bradford C Newton |
Corporate Director |
Aug 16, 2021 | |
| Robert a Cherry |
Corporate Director |
May 5, 2017 | |
| Larry L Innocent |
Corporate Director |
Sep 19, 2011 | |
| Adventist Health System/West |
Operational/Managerial Control | Jun 16, 1980 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041015000818 | CA | Part B Supplier - Clinic/Group Practice | 6406816123 |
Receives reassigned benefits from 197 practitioners Practice locations: Ukiah, CA |
| O20080108000652 | CA | Part a Provider - Hospital | 6406816123 | Practice locations: Ukiah, CA |
National Provider Directory
Locations
487 S Main St
Lakeport, CA 95453
Phone (707) 263-4360
901 Dover Dr
Ste 126
Newport Beach, CA 92660
Phone (949) 873-5089
2356 Sutter St
#J140
San Francisco, CA 94115
Phone (415) 353-2566
500 Doyle Park Dr
Ste 205
Santa Rosa, CA 95405
Phone (707) 303-8350
196 Wikiup Dr
Santa Rosa, CA 95403
Phone (707) 527-9517
487 S Main St
Ukiah, CA 95482
115 Hospital Dr
Ukiah, CA 95482
Phone (707) 463-1900
333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113
248 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-2924
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician |
207K00000X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| General Acute Care Hospital | 282N00000X | 110000095 | CA | Yes |
Addresses
Primary practice location
275 Hospital Dr
Ukiah, CA 95482-4531
Mailing address
PO Box 888867
Los Angeles, CA 90088-8867
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050301 | Other | CA | BLUE CROSS |
| ZZZC2308Z | Other | CA | BLUE SHIELD |
| ZZZ92403Z | Other | CA | BLUE SHIELD |
| ZZR00301F | Medicaid | CA | |
| 005433002 | Other | CA | KAISER |
| ZZZ13334Z | Other | CA | BLUE SHIELD |
| 195519900 | Other | CA | US DEPARTMENT OF LABOR |
| HSP40301F | Medicaid | CA | |
| ZZZ18251Z | Other | CA | BLUE SHIELD |
| ZZZC2307Z | Other | CA | BLUE SHIELD |
Other names
- Adventist Health Ukiah Valley
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC / Office Ally |
Other providers in Ukiah, CA
- Tiffany Francis Tucker
- Mary Turner
- Keenan P Tyner
- Brittany Denise Tyrrell
- Ukiah Adventist Hospital
- Ukiah Adventist Hospital
- Ukiah Adventist Hospital
- Ukiah Adventist Hosptial
- Ukiah Adventist Hosptial
- Ukiah Obstetrics and Gynecology
All providers in Ukiah, CA · General Acute Care Hospital in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.