Organization Active NPI

Dap Health, Inc.

Doing business as DAP Health-Stonewall Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Cathedral City, CA
National Provider Identifier
1386180404
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DAP HEALTH, INC.
Doing business as
DAP Health-Stonewall Community Health Center
Practice address
68555 Ramon Rd
Cathedral City, CA 92234-3310
Phone
(619) 873-3538
NPI assigned
Jan 12, 2017
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Judy Stith
Title
Chief Administrative Officer
Phone
(760) 323-2118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

68555 Ramon Rd
Cathedral City, CA 92234-3310

Mailing address

1695 N. Sunrise Way
Palm Springs, CA 92262
Phone (760) 323-2118

Other names 1

  • DAP Health-Stonewall Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100608000193 CA Part B Supplier - Clinic/Group Practice 6002989522 Receives reassigned benefits from 103 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thermal, CA; San Jacinto, CA; Cathedral City, CA; Palm Springs, CA; Escondido, CA; El Cajon, CA; Desert Hot Springs, CA; Coachella, CA…
O20240606004126 CA Part A Provider - Federally Qualified Health Center (FQHC) 6002989522 Practice locations: Cathedral City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386180404. Details of each certification follow.

Federally qualified health center certification: CCN 921023

Legal name
DAP HEALTH INC
Doing business as
DAP - STONEWALL COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 31, 2017
Last certification
Oct 31, 2017
Ownership / control type
For profit – corporation
Most recent change of ownership
Aug 1, 2023 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 1984 in CA
Enrollment address
68555 Ramon Rd
Ste 101, 103, 104, 105
Cathedral City, CA 92234-3310

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Dap Health Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

68555 Ramon Rd
#103
Cathedral City, CA 92234
Phone (760) 507-3310

68555 Ramon Rd
Ste 201207
Cathedral City, CA 92234

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
David Brinkman Individual Corporate OfficerCeo Aug 1, 2023 100%
Patrick Jordan Individual Corporate DirectorChair Aug 1, 2023
Frederick Drewette Individual Corporate DirectorTreasurer Aug 1, 2023
Gladis Adriana Perez Individual W-2 Managing EmployeeHealth Plan Coordinator Aug 1, 2023
Veronica Willimas Individual Corporate DirectorMember Feb 27, 2024
Judy Stith Individual Corporate OfficerChief Administrative Officer Aug 1, 2023
Athalie Lapamuk Individual Corporate DirectorMember Aug 1, 2023
Scot Karp Individual Corporate DirectorMember Jun 1, 2024
Mark Charles Adams Individual Corporate DirectorMember Jun 1, 2024
Kevin Bass Individual Corporate DirectorVice Co-Chair Aug 1, 2023
Carolyn Caldwell Individual Corporate DirectorMember Aug 1, 2023
Bruce Finch Individual Corporate DirectorMember Aug 1, 2023
Karyl Ketchum Individual Corporate DirectorMember Aug 1, 2023
Frank Figueroa Individual Corporate DirectorMember Aug 1, 2023
Eve Fromberg Individual Corporate DirectorVice Co-Chair Aug 1, 2023
Mark Hamilton Individual Corporate DirectorSecretary Aug 1, 2023

Change-of-ownership history 2

DateEventCounterparty
Aug 1, 2023 Change of OwnershipThis provider was the buyer Stonewall Medical CenterCCN 921023, CA, NPI 1386180404
Aug 1, 2023 Change of OwnershipThis provider was the seller Dap - Stonewall Community HealthCCN 921023, CA, NPI 1386180404

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1386180404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 N. SUNRISE WAY",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "92262",
            "telephone_number": "760-323-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68555 RAMON RD",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922343310",
            "telephone_number": "619-873-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAP HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "STITH",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "760-323-2118"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DAP Health-Stonewall Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cathedral City, CA

Sources for this page

Verify at the official NPI Registry.