NPIMap

Organization Active NPI

Lodi Memorial Hospital Association Inc

Doing business as Lodi Memorial Hospital

  • General Acute Care Hospital
  • Lodi, CA
National Provider Identifier
1316938301
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
030000056 Issued in CA
Legal business name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
Lodi Memorial Hospital
Practice address
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone
(209) 334-3411
Fax
(209) 339-7659
NPI assigned
Oct 31, 2005
Last updated
Jul 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Authorized official

Name
Katie J Delmore
Title
Finance Officer
Phone
(209) 339-7560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 030000056 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
Lodi, CA 95240-5118

Mailing address

PO Box 884577
Los Angeles, CA 90088-4577
Phone (209) 334-3411

Other identifiers 5

IdentifierTypeStateIssuer
ZZZC3903ZOtherCABLUE SHIELD IN & OUTPT
HSP40336FMedicaidCA
HSC00336FMedicaidCA
ZZR00336FOtherCACMSP DEPT OF HEALTH SVC
HSP40336FOtherCACHDP

Other names 1

  • Lodi Memorial Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050517000577 CA Part B Supplier - Clinic/Group Practice 7618880717 Receives reassigned benefits from 228 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, CA
O20060426000831 CA Part A Provider - Hospital 7618880717 Practice locations: Ione, CA; Lodi, CA
O20240725000722 CA Part B Supplier - Intensive Cardiac Rehabilitation 7618880717 Practice locations: Lodi, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316938301. Details of each certification follow.

Hospital certification: CCN 050336

Legal name
LODI MEMORIAL HOSPITAL ASSOCIATION INC
Doing business as
ADVENTIST HEALTH LODI MEMORIAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 23, 2021
Beds
190
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Dec 7, 1945 in CA
Enrollment address
975 S Fairmont Ave
Lodi, CA 95240-5118
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Adventist Health Lodi MemorialCCN 050336 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

387 Civic Dr
Galt, CA 95632
Phone (209) 745-8080

17305 Von Karman Ave
Ste 107
Irvine, CA 92614
Phone (949) 478-2230

1901 W Kettleman Ln
Ste 200
Lodi, CA 95242
Phone (209) 334-8540

2415 W Vine St
Ste 100
Lodi, CA 95242
Phone (209) 333-3121

2415 W Vine St
Ste 106
Lodi, CA 95242
Phone (209) 333-3066

801 S Ham Ln
Ste S
Lodi, CA 95242
Phone (209) 333-8066

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
Kerry L Heinrich Individual Corporate OfficerChairman of Board Jan 1, 2022
Corporate DirectorBoard Member Jun 1, 2015
John H Cress Individual Corporate Director Oct 1, 2024
Meredith S Jobe Individual Corporate OfficerSecretary Jun 1, 2015
Eric a Stevens Individual Corporate OfficerVice Chair Mar 5, 2025
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Joy a. Fehr Individual Corporate DirectorBoard Member Oct 1, 2020
Jonathan J Daggett Individual Corporate DirectorBoard Member Jan 1, 2024
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Ann K Beckett Individual Corporate DirectorBoard Member Jan 1, 2024
Marc K Woodson Individual Corporate DirectorBoard Member Jan 1, 2019
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jack W Wagner Individual Corporate DirectorBoard Member Dec 1, 2022
Bradford C Newton Individual Corporate DirectorBoard Member Aug 16, 2021
Katherine Delmore Individual Corporate OfficerTreasurer Sep 18, 2022 100%
W-2 Managing EmployeeFinance Officer Sep 18, 2022
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Jun 1, 2015
Brooke McCollough Individual Corporate OfficerPresident Aug 18, 2022 100%
Donovan Stewart Individual Corporate OfficerCno Jun 15, 2021
Adventist Health System/West Organization, Roseville, CA Non-profit Operational/Managerial Control Jun 1, 2015 100%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Adventist Health Lodi MemorialGalt, CA, CCN 058546 Rural health clinic Operational/Managerial Control (100%) May 16, 2013

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 105

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

View all 105

Practitioners & affiliated clinicians

Practitioners 250

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 250

Affiliated clinicians 347

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

View all 347

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1316938301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 884577",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900884577",
            "telephone_number": "209-334-3411",
            "fax_number": "209-339-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-334-3411",
            "fax_number": "209-339-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI MEMORIAL HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "DELMORE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "FINANCE OFFICER",
        "authorized_official_telephone_number": "209-339-7560"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "030000056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD IN & OUTPT",
            "identifier": "ZZZC3903Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40336F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC00336F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMSP DEPT OF HEALTH SVC",
            "identifier": "ZZR00336F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHDP",
            "identifier": "HSP40336F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "975 S Fairmont Ave",
            "city": "Lodi",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952405118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lodi Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lodi Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.