Corcoran District Hospital

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

040000087 Issued in CA

Legal business name

CORCORAN DISTRICT HOSPITAL

Practice address

1310 Hanna Ave
Corcoran, CA 93212-2314

Phone

(559) 992-5051

Fax

(559) 992-3972

NPI assigned

May 31, 2005

Last updated

Sep 7, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie Bach

Title

Cfo

Phone

(559) 992-5051

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255334595. Details of each certification follow.

• CCN 050349 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 050349

Legal name

CORCORAN DISTRICT HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Oct 1, 2013

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Mar 19, 2013

Beds

32

Ownership / control type

State

Facility address

1310 Hanna Ave
Corcoran, CA 93212

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Corcoran District Hospital

  dba Corcoran District Hospital Health Center

  • Rural Health Clinic/Center
  • Corcoran, CA
  • NPI 1255460176
  NPPES parent name

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1255334595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 HANNA AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932122314",
            "telephone_number": "559-992-5051",
            "fax_number": "559-992-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HANNA AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932122314",
            "telephone_number": "559-992-5051",
            "fax_number": "559-992-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORCORAN DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "BACH",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "559-992-5051"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "040000087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40349F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC30349F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30349F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shiveta Cherwoo
• Caitlin Chinn-Goshgarian, PH.D.
• Barry Chong, PH.D.
• Kassandre J Clayton, LCSW
• Constance G Colevins-Tumlin
• Corcoran District Hospital (Corcoran District Hospital Health Center)
• Corcoran Joint Unfied School District
• Corrections and Rehabilitation-Headquarters (Corcoran State Prison Hospital Pharmacy)
• Corrections and Rehabilitation-Headquarters (Calif Substance Abuse Treatment Facility State Prison Corcoran)
• Michael Anthony Cortez, DDS

• General Acute Care Hospital in Corcoran, CA
• Providers in Corcoran, CA by specialty
• General Acute Care Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.