NPIMap

Organization Active NPI

Enloe Medical Center

  • Home Health Agency
  • Chico, CA
National Provider Identifier
1376626903
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
230000081 Issued in CA
Legal business name
ENLOE MEDICAL CENTER
Practice address
1390 E Lassen Ave
Chico, CA 95973-7823
Phone
(530) 332-7479
Fax
(530) 893-6853
NPI assigned
Oct 24, 2006
Last updated
Jan 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ENLOE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Authorized official

Name
Mr. Christine Venard
Title
Director, PFS
Phone
(530) 332-6331

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 230000081 CA Primary
Respite Care 385H00000X

Addresses

Primary practice location

1390 E Lassen Ave
Chico, CA 95973-7823

Mailing address

1531 Esplanade
Attn: Finance
Chico, CA 95926-3310
Phone (530) 332-7357

Other identifiers 1

IdentifierTypeStateIssuer
HHA07661FMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040813000754 CA Part A Provider - Home Health Agency 9739092388 Practice locations: Chico, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376626903. Details of each certification follow.

Home health agency certification: CCN 057661

Legal name
ENLOE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 17, 1984
Last certification
Sep 20, 2013
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
May 23, 1983 in CA
Enrollment address
1390 E Lassen Ave
Chico, CA 95973-7823

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Care Compare: Home health agency

Medicare Care Compare
Listed as
Enloe Medical Center Home Health AgencyCCN 057661 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Sep 17, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Enloe General Colorectal S18 organizations share this tax ID, including this one
Part of
Enloe General Colorectal S

Other organizations with this tax ID 17

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

View all 17

Locations

1665 Esplanade
Chico, CA 95926
Phone (530) 332-5070

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Craig Duncan Individual Corporate DirectorBoard Chair Jan 1, 2020
Denise Adams Individual Corporate DirectorBoard Vice Chair Jan 1, 2020
William Carriere Individual Corporate DirectorBoard Secretary Jan 1, 2020
Kevin Woodward Individual Corporate DirectorCfo/Corporate Officer Jan 1, 2019
Michael Wiltermood Individual Corporate OfficerCeo Oct 1, 2010
Corporate DirectorCeo Oct 1, 2010
W-2 Managing EmployeeCeo Oct 1, 2010

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1376626903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "address_2": "ATTN: FINANCE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-7357",
            "fax_number": "530-893-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 E LASSEN AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737823",
            "telephone_number": "530-332-7479",
            "fax_number": "530-893-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLOE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENLOE MEDICAL CENTER",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "VENARD",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "DIRECTOR, PFS",
        "authorized_official_telephone_number": "530-332-6331",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "230000081",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA07661F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.