NPIMap

Organization Active NPI

Mayers Memorial Hospital District

  • Skilled Nursing Facility
  • Fall River Mills, CA
National Provider Identifier
1386763456
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAYERS MEMORIAL HOSPITAL DISTRICT
Practice address
43563 Highway 299 East
Fall River Mills, CA 96028-0459
Phone
(530) 336-5511
Fax
(530) 336-6199
NPI assigned
Mar 28, 2007
Last updated
May 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Authorized official

Name
Mr. Matt Rees
Title
Ceo
Phone
(530) 336-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X CA Primary

Addresses

Primary practice location

43563 Highway 299 East
Fall River Mills, CA 96028-0459

Mailing address

PO Box 459
Fall River Mills, CA 96028
Phone (530) 366-5511

Other identifiers 1

IdentifierTypeStateIssuer
LTC06416FOtherCAOTHER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120502000720 CA Part A Provider - Skilled Nursing Facility 6305804196 1 other NPI on this enrollment
Practice locations: Fall River Mills, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386763456. Details of each certification follow.

Skilled nursing facility certification: CCN 056416

Legal name
MAYERS MEMORIAL HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Nov 8, 1973
Last certification
May 9, 2024
Beds
99
Ownership / control type
Hospital District
Organization structure
OtherNon-profit
Enrollment address
43563 State Highway 299 E
Fall River Mills, CA 96028-9787
Nursing home name
MAYERS MEMORIAL HOSPITAL

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 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mayers Memorial HospitalCCN 056416 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Government - Hospital district
Certified
Nov 8, 1973
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9969.0 residents per day on average
Penalties (3 years)
3Fines totaling $62,258

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Mayers Memorial Hospita7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Theresa Overton Individual Operational/Managerial Control Oct 5, 2022
Adp of the SNF Oct 5, 2022
Ryan Harris Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Travis Lakey Individual Corporate OfficerCfo Nov 23, 2009
Operational/Managerial ControlCfo Nov 23, 2009
Adp of the SNF Nov 23, 2009
Mayers Memorial Hospital District Organization, Fall River Mills, CA 5% Or Greater Direct Ownership Interest Oct 2, 1969 100%
Operational/Managerial Control Oct 2, 1969
Trustee of the SNF Oct 2, 1969
Adp of the SNF Oct 2, 1969

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Mayers Memorial Hospital DistrictFall River Mills, CA, CCN 051305 Hospital Other (100%) Oct 3, 1969
Mayers Memorial Hospital DistrictFall River Mills, CA, CCN 05Z305 Hospital Operational/Managerial Control (100%) Feb 11, 2015
Intermountain HospiceFall River Mills, CA, CCN 051738 Hospice Operational/Managerial Control (100%) Jan 1, 1999
Mayers Memorial Hospital DistrictBurney, CA, CCN 058721 Rural health clinic Other Oct 3, 1969

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1386763456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "96028",
            "telephone_number": "530-366-5511",
            "fax_number": "530-366-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43563 HIGHWAY 299 EAST",
            "city": "FALL RIVER MILLS",
            "state": "CA",
            "postal_code": "960280459",
            "telephone_number": "530-336-5511",
            "fax_number": "530-336-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYERS MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "REES",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-336-5511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "LTC06416F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River Mills, CA

Sources for this page

Verify at the official NPI Registry.