NPIMap

Organization Active NPI

The Vineyards at Fowler LLC

  • Skilled Nursing Facility
  • Fowler, CA
National Provider Identifier
1376201046
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
THE VINEYARDS AT FOWLER LLC
Practice address
1306 E Sumner Ave
Fowler, CA 93625-2627
Phone
(559) 834-2542
NPI assigned
Nov 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Authorized official

Name
Aaron Chesley
Title
Manager
Phone
(559) 834-2542

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X
Physical Therapy Clinic/Center 261QP2000X
Occupational Medicine Clinic/Center 261QX0100X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1306 E Sumner Ave
Fowler, CA 93625-2627

Mailing address

662 Encinitas Blvd Ste 216
Encinitas, CA 92024-6790
Phone (760) 652-6354

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230530002244 CA Part A Provider - Skilled Nursing Facility 0840679122 Practice locations: Fowler, CA

Skilled nursing facility certification: CCN 055454

Legal name
THE VINEYARDS AT FOWLER LLC
Doing business as
VINEYARDS AT FOWLER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1973
Last certification
Sep 20, 2024
Beds
49
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Oct 11, 2021 in CA
Enrollment address
1306 E Sumner Ave
Fowler, CA 93625-2627
Nursing home name
VINEYARDS AT FOWLER
Affiliated entity
AJC HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Vineyards at FowlerCCN 055454
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4944.1 residents per day on average
Chain
Ajc Healthcare14 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ajc Healthcare LLC Organization, Carlsbad, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2021 50%
SWC Ca Opco 2 LLC Organization, Carlsbad, CA LLC 5% Or Greater Direct Ownership Interest Nov 1, 2021 100%
Aaron Chesley Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2021 50%
Corporate OfficerManager Nov 1, 2021
Simon Holguin Individual W-2 Managing EmployeeAdministrator Nov 1, 2021
James B Gamett Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2021 50%
Corporate OfficerManager Nov 1, 2021
JBG Partners LLC Organization, Carlsbad, CA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2021 50%

Facilities with the same owner 19

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

View all 19

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1376201046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 ENCINITAS BLVD STE 216",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920246790",
            "telephone_number": "760-652-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 E SUMNER AVE",
            "city": "FOWLER",
            "state": "CA",
            "postal_code": "936252627",
            "telephone_number": "559-834-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VINEYARDS AT FOWLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "CHESLEY",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "559-834-2542"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fowler, CA

Sources for this page

Verify at the official NPI Registry.