NPIMap

Organization Active NPI

Reedley Community Hospital

Doing business as Adventist Health Community Care-Corcoran East

  • Rural Health Clinic/Center
  • Corcoran, CA
National Provider Identifier
1235475484
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
040000149 Issued in CA
Legal business name
REEDLEY COMMUNITY HOSPITAL
Doing business as
Adventist Health Community Care-Corcoran East
Adventist Health Reedley - Corcoran East
Practice address
1310 Hanna Ave
Suite 1 & 3
Corcoran, CA 93212-2314
Phone
(559) 992-8200
Fax
(559) 992-8673
NPI assigned
Dec 17, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Andrea Kofl
Title
Central Valley Network President
Phone
(559) 537-0056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 040000149 CA Primary

Addresses

Primary practice location

1310 Hanna Ave
Suite 1 & 3
Corcoran, CA 93212-2314

Mailing address

PO Box 888806
Los Angeles, CA 90088-8806
Phone (559) 992-8200

Other names 2

  • Adventist Health Community Care-Corcoran East Doing business as
  • Adventist Health Reedley - Corcoran East Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130313000199 CA Part A Provider - Rural Health Clinic 0941460984 Practice locations: Corcoran, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235475484. Details of each certification follow.

Rural health clinic certification: CCN 058666

Legal name
REEDLEY COMMUNITY HOSPITAL
Doing business as
ADVENTIST HEALTH REEDLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 11, 2013
Last certification
May 9, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2011 in CA
Enrollment address
1310 Hanna Ave
Ste 1&3
Corcoran, CA 93212-2314
Related CCNs
050192

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

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
05D2057558Adventist Health-Reedley1310 Hanna Avenue, Corcoran, CA 93212Provider-performed microscopyApr 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Reedley Community Hospital37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Kerry L Heinrich Individual Corporate DirectorChair Jan 1, 2022
Velino a Salazar Individual Corporate DirectorBoard Member Sep 14, 2015
Meredith S Jobe Individual Corporate DirectorSecretary Mar 13, 2014
Andrea S Kofl Individual Corporate OfficerPresident Feb 27, 2017
W-2 Managing EmployeePresident/Ceo Feb 27, 2017
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Andrew R Davis Individual Corporate Director May 5, 2017
Todd N Hofheins Individual Corporate DirectorBoard Member Jan 26, 2022
Lucy a Ocampo Individual Corporate DirectorBoard Member Jul 1, 2019
David P Banks Individual Corporate DirectorBoard Member May 5, 2017
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Timothy M Haydock Individual Corporate OfficerTreasurer/Assistant Secretary Jul 3, 2017
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Non-profit Other Dec 17, 2012 100%

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1235475484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888806",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900888806",
            "telephone_number": "559-992-8200",
            "fax_number": "559-992-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HANNA AVE",
            "address_2": "SUITE 1 & 3",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932122314",
            "telephone_number": "559-992-8200",
            "fax_number": "559-992-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEDLEY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "KOFL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CENTRAL VALLEY NETWORK PRESIDENT",
        "authorized_official_telephone_number": "559-537-0056"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "040000149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Community Care-Corcoran East",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Community Care-Corcoran East",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adventist Health Reedley - Corcoran East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corcoran, CA

Sources for this page

Verify at the official NPI Registry.