NPIMap

Organization Active NPI

Fresno Community Hospital and Medical Center

Doing business as Clovis Community Medical Center

  • General Acute Care Hospital
  • Clovis, CA
National Provider Identifier
1316027709
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
040000004 Issued in CA
Legal business name
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Doing business as
Clovis Community Medical Center
Practice address
2755 Herndon Ave
Clovis, CA 93611-6800
Phone
(559) 459-1672
Fax
(559) 459-1058
NPI assigned
Oct 17, 2006
Last updated
Jun 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Mr. Craig Allen Wagoner
Title
Ceo
Phone
(559) 324-4266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 040000004 CA Primary

Addresses

Primary practice location

2755 Herndon Ave
Clovis, CA 93611-6800

Mailing address

2755 Herndon Ave
Clovis, CA 93611-6800
Phone (559) 324-4000

Other names 1

  • Clovis Community Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030602000052 CA Part A Provider - Hospital 3173430865 Practice locations: Clovis, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316027709. Details of each certification follow.

Hospital certification: CCN 050492

Legal name
FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Doing business as
CLOVIS COMMUNITY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 31, 1967
Last certification
Jun 12, 2025
Beds
352
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 13, 1945 in CA
Enrollment address
2755 Herndon Ave
Clovis, CA 93611-6800
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Clovis Community Medical CenterCCN 050492 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Fresno Community Hospit22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Keith B Boone Individual Corporate DirectorBoard MBR Apr 3, 2018
Deborah P Moffett Individual Corporate OfficerVice Treasurer Jan 1, 2012
W-2 Managing EmployeeVP Finance Administration Sep 1, 2009
Operational/Managerial ControlVice Treasurer Jan 1, 2012
Susan M Abundis Individual Corporate DirectorBoard MBR Jan 1, 2017
Gregory L Copeland Individual Corporate DirectorBoard Member Feb 25, 2025
Gregory Carl Estep Individual Corporate DirectorBoard Member Jan 1, 2020
Roger E Sturdevant Individual Corporate OfficerChair Apr 12, 2023
Corporate DirectorBoard MBR Jan 1, 2018
Craig Wagoner Individual Corporate OfficerChief Executive Officer Feb 3, 2025
W-2 Managing EmployeeChief Executive Officer Feb 3, 2025
Operational/Managerial ControlChief Executive Officer Feb 3, 2025
Gerardo Hernandez Individual Corporate DirectorBoard Member Jun 6, 2023
Nicholas David Dugan Individual Corporate DirectorBoard Member Feb 25, 2025
Mark J Coelho Individual Corporate DirectorBoard Member Feb 7, 2023
Fabiola Gonzalez Individual Corporate DirectorBoard Member May 20, 2025
Isabel D Martinez Individual Corporate OfficerVice Secretary Jan 1, 2023
Chandrasekar Venugopal Individual Corporate DirectorBoard MBR Jan 1, 2018
Leland D Parnagian Individual Corporate DirectorBoard Member Feb 7, 2023
Christopher M Neuman Individual Corporate OfficerEvp Chief Finance & Adminis Officer Jan 1, 2023
W-2 Managing EmployeeEvp Chief Finance & Adminis Officer Jan 1, 2023
Operational/Managerial ControlEvp Chief Finance & Adminis Officer Jan 1, 2023
Lori Anne Bennett Individual Corporate DirectorBoard Member May 4, 2022
Community Hospitals of Central California Organization, Clovis, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 10, 1982 100%
Katherine R. Melendez Individual Corporate OfficerSecond Vice Secretary Jan 1, 2023
Karen M McCaffrey Individual Corporate OfficerBoard Secretary Jan 1, 2023
Corporate DirectorBoard Member May 7, 2019

Owners & managing parties with NPI records 3

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 921

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

View all 921

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1316027709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116800",
            "telephone_number": "559-324-4000",
            "fax_number": "559-324-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116800",
            "telephone_number": "559-459-1672",
            "fax_number": "559-459-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "WAGONER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-324-4266",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "040000004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clovis Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clovis Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.